Overview Provides care management through a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet member's health needs through communication and available resources, while promoting quality cost-effective outcomes. Maintains members in the most independent living situation possible; ensures consistent care along entire health care continuum by assessing and closely monitoring members' needs and status. Provides care management services and authorizes/ coordinates services within a capitated managed care system. Communicates and collaborates with primary care practitioners, interdisciplinary team and family members.
What We Provide Referral bonus opportunities
Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays
Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability
Employer-matched retirement savings funds
Personal and financial wellness programs
Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care
Generous tuition reimbursement for qualifying degrees
Opportunities for professional growth and career advancement
Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities
What You Will Do Assesses, plans and provides intensive and continuous care management across acute, home, and long-term care settings. Develops and negotiates care plans with members, families and physicians.
Assesses a person’s living condition/situation, cultural influences, and functioning to identify the individual’s needs; develops a comprehensive care plan that addresses those needs.
Assesses an enrollee’s eligibility for Program services based on health, medical, financial, legal and psychosocial status, initially and on an ongoing basis.
Plans specific objectives, goals and actions designed to meet the member’s needs as identified in the assessment process that are action-oriented, time-specific and cost effective.
Implements specific care management activities and/or interventions that lead to accomplishing the goals set forth in the plan of care.
Coordinates, facilitates and arranges for long term care services in the home and community-based sites; arranges for on-going nursing care, service authorization and periodic assessment.
Collaborates and negotiates with interdisciplinary teams, health care providers, family members, and third party payors across health settings to ensure optimum delivery and coordination of services to members.
Monitors care management activities, services, and members’ responses to interventions to determine effectiveness of the plan of care and utilization of services.
Evaluates the effectiveness of the plan of care in reaching desired outcomes and makes modifications as needed.
Identifies trends and needs of groups in the community and plans interventions based on these needs.
Provides care management services across sites and collaborates with appropriate facility discharge planner and/or HCC when members are transitioned between settings.
Manages expenditures to ensure effective use of covered services within a capitated rate; fiscally responsible in providing services based on members’ needs.
Provides social work services in accordance with NASW code of ethics, VNS Health policies, practices, and procedures.
Participates in outreach activities to promote knowledge of the Program and its services and to coordinate Program activities with outside community agencies and health care providers (e.g., community health screening).
Participates in the development of programs to meet the specialized needs of this selected patient population.
Documents services in accordance with Health Plans Community Care standards and MLTC and LHCSA regulations.
Participates in special projects and performs other duties as assigned.
Qualifications Licenses and Certifications License and current registration to practice as a Licensed Social Worker in New York State preferred
Education Master\'s Degree in Social Work required
Case Management Certification preferred
Work Experience Minimum of three years of Social Work experience required
Minimum of two years in a case management and/or community based environment preferred
Bilingual skills may be required, as determined by operational needs.
Clinical expertise in geriatrics, Long Term care and Managed care experience preferred
Pay Range : USD $70,200.00 - USD $87,700.00 /Yr.
About Us VNS Health is one of the nation’s largest nonprofit home and community-based health care organizations. Innovating in health care for more than 130 years, our commitment to health and well-being drives us. More than 10,000 VNS Health team members deliver compassionate care and 24/7 resources to over 43,000 neighbors who look to us for care. We offer a full range of health care services, solutions and health plans to meet diverse needs in New York and beyond.