Care Manager
3 months ago
Position Overview
The Care Manager under the direction of the Vice President of Clinical Services, is primarily responsible for managing both simple and complex medical cases to achieve high-quality patient care outcomes and minimize unnecessary medical expenses, through the coordination of services, both outpatient and inpatient. The Care Manager will assist the provider in directing care to the most appropriate setting, evaluating alternative care plans, and assessing outcomes through outreach to the members.
Job Description
Performs care management including hospital admission certification, continued stay review, discharge planning, outpatient, and ancillary services review, etc., following established MetroPlusHealth Utilization Management policies, procedures, and protocols. Oversee the coordination and delivery of comprehensive, quality healthcare and services for all members requiring care management in a cost-effective manner. Interacts and obtains relevant clinical information from members’ PCP and other providers; approves care that meets established criteria; and refers all other cases to the MetroPlusHealth Physician Advisor/Medical Director. Informs member and provider of Utilization Management determinations and treatment alternatives. Identifies utilization trends and potential member needs by means of generating reports of encounter data, pharmacy data review, and new member health assessment forms. Evaluate member needs for referred cases (from providers or member self-referred). Assists all departments with the resolution of members’ problems related to utilization management issues. Performs all Utilization Management activities in compliance with all regulatory agency requirements. Conducts medical record reviews as appropriate to case management functions. Participate in Medical Management grand rounds with the Physician Advisor. Performs all other duties as assigned
Minimum Qualifications
High School Diploma General Equivalency Diploma (GED) required; and 2-5 years’ clinical experience in an acute or applicable care setting. UM/UR experience in managed care or hospital setting required. New York State license as Registered Nurse, License Practical Nurse, or Physical Therapist requiredProfessional Competencies
Integrity and Trust Customer Focus Excellent communication, written and analytical skills. Knowledge of computer systems.-
Care Manager
4 weeks ago
New York, New York, United States Care Collab Full timeJob SummaryCareCollab is seeking a skilled Care Manager to lead the engagement and coordination of comprehensive care and services for high-utilization Medicaid members with chronic medical and behavioral health conditions. This role is crucial in addressing the holistic needs of our members, including behavioral, medical, and social aspects.Key...
-
Nurse Care Manager
2 weeks ago
New York, United States Village Care Full timeJob DescriptionVillage Care is seeking a skilled RN Care Manager to join our team in a remote capacity. As a key member of our care management team, you will be responsible for providing high-quality care and support to our diverse patient population in the greater NYC area.Key Responsibilities:Develop and implement individualized care plans to meet the...
-
Nurse Care Manager
2 weeks ago
New York, United States Village Care Full timeJob Title: RN- Care ManagerJob SummaryVillage Care is seeking a skilled RN- Care Manager to join our team in a full-time, remote position. As a key member of our care management team, you will be responsible for providing high-quality care and support to our diverse patient population in the greater NYC area.Key ResponsibilitiesDevelop and implement...
-
Care Management Director
4 weeks ago
New York, New York, United States Fidelis Care Full timeJob SummaryWe are seeking a highly skilled and experienced Care Management Director to join our team at Fidelis Care. As a key member of our leadership team, you will be responsible for managing the LTSS Nurses team to develop and assess high-quality, cost-effective healthcare outcomes.Key Responsibilities:Oversee and review intake required documentation to...
-
Care Manager
4 weeks ago
New York, United States Care Design New York Full timeOverview: As a Care Design New York Care Manager, you will help people with intellectual and/or development disabilities identify and realize their long-term and short-term goals by developing, implementing, and monitoring their person-centered Life Plans. These plans help our members live their best life so well count on your best relational and...
-
Care Manager
1 week ago
New York, New York, United States Castle Rock Home Care Full timeCastle Rock Home Care is seeking a skilled Home Health Coordinator to join our team.Key Responsibilities:Coordinate home health care services for patientsCollaborate with healthcare teams to ensure quality careManage patient records and communicate with familiesRequirements:Experience with HHA exchangeExcellent communication and teamwork skillsWhat We...
-
Care Manager
4 weeks ago
New York, New York, United States ADVANCE CARE ALLIANCE OF NY INC Full timeJob SummaryWe are seeking a highly skilled and compassionate Care Manager to join our team at Advance Care Alliance of NY Inc. As a Care Manager, you will play a critical role in providing person-centered care management services to individuals with intellectual and developmental disabilities.Key ResponsibilitiesDeliver comprehensive care management services...
-
Care Manager
4 weeks ago
New York, New York, United States ADVANCE CARE ALLIANCE OF NY INC Full timeJob SummaryWe are seeking a highly skilled and compassionate Care Manager to join our team at Advance Care Alliance of NY Inc. As a Care Manager, you will play a critical role in providing person-centered care management services to individuals with intellectual and developmental disabilities.Key ResponsibilitiesDeliver comprehensive care management services...
-
Transitional Care Manager
4 weeks ago
New York, New York, United States BAYADA Home Health Care Full timeJoin Our Team as a Transitional Care ManagerBAYADA Home Health Care is seeking a skilled Transitional Care Manager to join our team. As a Transitional Care Manager, you will play a critical role in coordinating the transition of patients from hospital to home, ensuring seamless care and optimal outcomes.Key Responsibilities:Develop strong relationships with...
-
Care Management Support Specialist
4 weeks ago
New York, New York, United States Fidelis Care Full timeJob SummaryWe are seeking a highly motivated and detail-oriented Care Management Support Coordinator II to join our team. As a key member of our care management team, you will play a critical role in supporting our members and providers in achieving their health goals.Key ResponsibilitiesApply working knowledge of assigned health plan activities and...
-
Care Team Assistant Manager
1 month ago
New York, New York, United States FREEDOM CARE , LLC Full timeAssistant Manager, Care TeamWe are seeking an experienced and skilled Assistant Manager to join our Care Team at FreedomCare, LLC. As a key member of our leadership team, you will play a vital role in ensuring the delivery of exceptional care to our patients and their families.Key Responsibilities:Oversee day-to-day operations of the Care Team, ensuring...
-
Care Manager
2 weeks ago
New York, New York, United States Care Collab Full timeJob SummaryCareCollab is seeking a skilled Care Manager to lead the engagement and coordination of comprehensive care and services for high-utilization Medicaid members with chronic medical and behavioral health conditions.This role is crucial in addressing the holistic needs of our members, including behavioral, medical, and social aspects. Key...
-
Behavioral Health Care Manager
2 weeks ago
New York, New York, United States PM Pediatric Care Full timeJob SummaryWe are seeking a highly skilled Behavioral Health Care Manager to join our team at PM Pediatric Care. As a key member of our primary care team, you will provide brief, immediate behavioral health interventions as part of integrated primary care services.Key ResponsibilitiesProvide quick and accurate clinical assessments for patients using...
-
Care Manager Position
4 weeks ago
New York, United States ADVANCE CARE ALLIANCE OF NY INC Full timeJob SummaryAdvance Care Alliance of NY Inc is seeking a highly skilled Care Manager to join our team. As a Care Manager, you will be responsible for providing comprehensive care management services to individuals with intellectual and developmental disabilities. This is a remote position with a blend of work from home, field work, and regional travel.Key...
-
Nurse Care Manager
3 days ago
New York, New York, United States RCM Health Care Services Full timeJob DescriptionAs a Nurse Care Manager - MLTC, you will be responsible for the care management of a defined population with the plan. Your primary goal will be to develop and implement care plans that are of good quality and appropriate to the needs of the members. You will work closely with the members, their families, and other healthcare professionals to...
-
Care Manager Position
4 weeks ago
New York, United States ADVANCE CARE ALLIANCE OF NY INC Full timeJob SummaryAdvance Care Alliance of NY Inc is seeking a highly skilled Care Manager to join our team. As a Care Manager, you will be responsible for providing comprehensive care management services to individuals with intellectual and developmental disabilities. This is a full-time position with a blend of work from home, field work, and regional travel.Key...
-
Care Manager
1 month ago
New York, New York, United States Castle Rock Home Care Full timeJob Title: Home Care CoordinatorWe are seeking a skilled and compassionate Home Care Coordinator to join our team at Castle Rock Home Care.Key Responsibilities:Coordinate home care services for patients with complex needsCollaborate with healthcare providers to ensure seamless care transitionsDevelop and implement personalized care plansProvide education and...
-
Care Manager
2 weeks ago
New York, New York, United States Castle Rock Home Care Full timeCastle Rock Home Care - Job OpportunityWe are seeking a skilled and compassionate Home Care Coordinator to join our team.The ideal candidate will have experience working with the HHA Exchange and possess excellent communication and teamwork skills.Responsibilities will include:Coordinating home care services for clientsCollaborating with healthcare...
-
RN Clinical Manager
3 weeks ago
New York, New York, United States Affirmed Home Care Full timeJob Title: RN Clinical ManagerAffirmed Home Care is seeking a highly skilled and experienced RN Clinical Manager to join our team in New York City. As a key member of our clinical leadership team, you will be responsible for developing and implementing patient-specific care plans, ensuring the quality of patient care, and supervising and supporting our home...
-
Care Manager
14 hours ago
New York, United States Care Design New York Full time $31 - $33Overview:Do you have the right skills and experience for this role Read on to find out, and make your application.As a Care Design New York Care Manager, you will help people with intellectual and/or development disabilities identify and realize their long-term and short-term goals by developing, implementing, and monitoring their person-centered Life Plans....
