The Care Manager plans and manages behavioral and/or physical care for members and beneficiaries. Collaborating with clinicians and healthcare team members, the Care Manager facilitates medical attention and addresses member needs across the care continuum. Assigned to specific product lines like FIDA and Medicaid/Medicare, this fully remote position supports the HARP LTSS team.
Key responsibilities
- Advocating, informing, and educating beneficiaries on services and self-management techniques.
- Conducting assessments to identify intervention opportunities.
- Developing care plans aligned with physician treatment goals.
- Coordinating with healthcare teams to maximize member outcomes.
- Documenting all interactions in compliance with internal procedures.
Duties/Responsibilities
- Advocating, informing, and educating beneficiaries on services, self-management techniques, and health benefits.
- Conducting assessments to identify barriers and opportunities for intervention.
- Developing care plans that align with the physician's treatment plans and recommends interventions that align with proposed goals.
- Generating referrals to providers, community-based resources, and appropriate services and other resources to assist in goal achievement.
- Collaborating with provider doctors, social workers, discharge planners, and community-based service providers to coordinate care accordingly.
- Coordinating and facilitating with the multi-disciplinary healthcare team as necessary to ensure care plan goals are achieved and maximize member outcomes.
- Assisting in identifying opportunities for alternative care options based on member needs and assessments.
- Evaluating service authorizations to ensure alignment and execution of the member's care and physician treatment plan.
- Contributing to corporate goals through ongoing execution of member care plans and member goal achievement.
- Documenting all encounters with providers, members, and vendors in the appropriate system in accordance with internal and established documentation procedures; follows up as needed; and updates care plans based on member needs, as appropriate.
- Occasional overtime as necessary.
- Additional duties as assigned.
Minimum Qualifications
- NYS RN or LCSW, LMSW, LMFT, LMHC, LPC, licensed psychologist (any state)
Preferred Qualifications
- Strong interpersonal and assessment skills.
- Fluency in Spanish, Korean, Mandarin, or Cantonese.
- Knowledge and experience with current community health practices.
- Experience managing member information in a shared network environment.
- Experience and knowledge of relevant product lines.
- Proficiency with Microsoft Excel and electronic documentation systems.
Hiring Range
- Greater New York City Area (NY, NJ, CT residents): $81,099 - $116,480
- All Other Locations: $71,594 - $106,080
Benefits
- Health, dental, and vision coverage
- Life insurance and 401k contributions
- Remote work opportunities and flexible schedules
Equal Opportunity Employer.
Applicants evaluated without regard to disability, race, color, religion, gender, sexual orientation, national origin, age, or other protected status.
Perks and Benefits
- Health Insurance
- Dental Insurance
- Vision Insurance
- Life Insurance
- Short-Term Disability
- Long-Term Disability
- FSA
- HSA
- Fitness Subsidies
- Mental Health Benefits
Parental Benefits
- Birth Parent Or Maternity Leave
- Family Support Resources
Work Flexibility
- Remote Work Opportunities
- Hybrid Work Opportunities
Office Life And Perks
- Commuter Benefits Program
- Casual Dress
- Happy Hours
- Company Outings
- Holiday Events
Vacation And Time Off
- Paid Vacation
- Paid Holidays
- Personal/Sick Days
- Volunteer Time Off
Financial And Retirement
- 401(K) With Company Matching
- Performance Bonus
Professional Development
- Internship Program
- Tuition Reimbursement
- Promote From Within
- Access To Online Courses
- Lunch And Learns
- Associate Or Rotational Training Program
- Learning And Development Stipend
Diversity And Inclusion
- Employee Resource Groups (ERG)
- Woman Founded/Led
- Diversity, Equity, And Inclusion Program
Apply quickly with Job ID: healthfirst-R017877
Employment Type: Other
Conclusion
Join our dedicated team at Healthfirst and make a difference as a Care Manager in our remote HARP LTSS program. With a focus on coordinating care for members with chronic conditions, you'll play a crucial role in advocating for beneficiaries, developing personalized care plans, and collaborating with healthcare professionals to achieve optimal outcomes.
Enjoy competitive compensation, comprehensive benefits, and the flexibility of remote work. Apply now and contribute to our mission of providing exceptional care across diverse communities.
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