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Clinical care manager
Location:
New York, NY
Description:
OverviewProvides telephonic clinical care management services using evidence-based practices to ensure effective utilization of benefits, services, and care is provided to the patients allowing them to remain safely in their home/community.Compensation:$93,400.00 - $116,800.00 AnnualWhat 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 saving 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 opportunitiesWhat You Will Do* Coordinates and/or oversees the coordination of benefits and services for all members on his/her caseload.* Completes care management and disease specific assessments.* Makes timely telephonic care management calls based on risk level.* Resolves and coordinates complex issues and member complaints impacting the delivery of services.* Provides health education to member/caregiver.* Assess SDo H and provide care coordination to reduce/remove barriers of care to include ability to allow for changing levels of care based on assessments, trigger events and program data/reports.* Identifies member safety issues and intervenes as necessary or refers to appropriate resources, such as community linkages, dietary, therapy (PT/OT/ST), HHA services, behavioral health, and DME.* Coordinates the delivery of high quality, cost-effective care based on a customized population model of care supported by evidence based clinical practice guidelines.* Advocates for the member/caregiver to obtain the health care and other services needed to optimize their quality of life.* Utilizes the Care Management process to set priorities, plan, organize and implement interventions that are goal directed towards self-care outcomes and the transition to independent status.* Promotes adherence to the physician treatment plan by providing education, coaching and support.* Educates, coordinates, and provides resources to reduce inappropriate utilization of emergency room (ER) and hospital service.* Increases utilization of primary care, specialty care, preventive health and guideline-based treatments including proper pharmacotherapy within network, as appropriate.* Participates in interdisciplinary team (IDT) meetings and provide input on customer service-related activities.* Protects the confidentiality of member information and adheres to company policies regarding confidentiality.* Ensures compliance with payors' policies and procedures as well as all Federal and State regulations.* Interprets and implements VNS Health policies, state and federal regulations.* Participates in special projects and performs other duties as assigned.QualificationsLicenses and Certifications:* License and current registration to practice as a Registered Professional Nurse in NYS required or* New York State License and current registration in Physical Therapy required or* New York State License and current registration in Occupational Therapy required* Certified Case Manager - Commission for Case Manager Certification within 1 year of employment requiredEducation:* Associate's Degree in nursing required or* Bachelor's Degree in Physical Therapy from a program approved by the New York State Department of Education required* Bachelor's Degree in nursing preferredWork Experience:* Minimum two years of experience in health related field required* Care management and/or managed care experience preferred* Proficiency in Microsoft Office applications required* Demonstrated analytical skills requiredFor more details: https://jobs-search.org/finance/clinical-care-manager_i2459726677
Posted:
November 17 on Jobs-Search
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More About this Listing: Clinical care manager
Clinical care manager is a Accounting & Finance Manager Job located in New York NY. Find other listings like Clinical care manager by searching Oodle for Accounting & Finance Manager Jobs.
Clinical care manager is a Accounting & Finance Manager Job located in New York NY. Find other listings like Clinical care manager by searching Oodle for Accounting & Finance Manager Jobs.