This range is provided by MetroPlusHealth. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.
Base pay range
$112,351.00/yr - $112,351.00/yr
Empower. Unite. Care.
MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.
About NYC Health + Hospitals
MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth's network includes over 27,000 primary care providers, specialists and participating clinics. For more than 40 years, MetroPlusHealth has been committed to building strong relationships with its members and providers.
Position Overview
The primary goal of the Care Manager is to optimize members’ health care and delivery of care experience with expected cost savings due to improved quality of care. This is accomplished through engagement and understanding of the member’s needs, environment, providers, support system and optimization of services available to them. Care Manager is expected to assess and evaluate member’s needs, be a creative, efficient, and resourceful problem solver. In collaboration with the members’ care team, a plan of care with individualized goals and interventions is developed, implemented and outcomes evaluated.
Work Shifts
9:00 A.M – 5:00 P.M
Duties & Responsibilities
Address member’s problems and needs: clinical, psychosocial, financial, environmental
Provide services to members of varying age, risk level, clinical scenario, culture, financial means, social support, and motivation
Engage members in a collaborative relationship, empowering them to self-manage their physical, psychosocial, and environmental health to improve and maintain lifelong wellbeing
Prepare member-oriented plan of care with member, caregivers, and health care providers, integrating concepts of cultural sensitivity and privacy practices
Participate in interdisciplinary rounds
Ensure plans of care have individualized goals and interventions
Communicate plan of care to Primary Care Physician
Address gaps in care with the member and provider
Address members social determinants of health issues
Link members to available resources
Provide care management support during Transitions of Care
Ensure member/caregiver understanding as it relates to language barriers, stress reaction or cognitive limitations/barriers
Train member on relevant chronic diseases, preventive care, medication management (medication reconciliation and adherence), home safety, etc.
Provide Complex care management including but not limited to ensuring access to care, reducing unnecessary hospitalizations, and appropriately referring to community supports
Advocate for members by assisting them to address challenges and make informed choices regarding clinical status and treatment options
Employ critical thinking and judgment when dealing with unplanned issues
Maintain knowledge of Chronic Conditions and use job aids as a guidance
Maintain accurate, comprehensive, and current clinical and non-clinical documentation in DCMS, the Care Management System
Comply with all orientation requirements, annual and other mandatory trainings, organizational and departmental policies and procedures, and actively participate in evaluation process
Maintain professional competencies as a Care Manager
Other duties as assigned by Manager
Minimum Qualifications
Bachelor’s Degree required
Minimum 2 years’ prior experience in a health care setting, Care Management, or Managed Care setting required
Ability to proficiently read and interpret medical records, claims data, pharmacy, lab reports and prescriptions required
Ability to work closely with member and caregiver.
Registered Nurse with current NYS license
Ability to work closely with member and caregiver.
Registered Nurse with current NYS license
Benefits
NYC Health and Hospitals offers a competitive benefits package that includes:
Comprehensive Health Benefits for employees hired to work 20+ hrs. per week
Retirement Savings and Pension Plans
Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts
Loan Forgiveness Programs for eligible employees
College tuition discounts and professional development opportunities