Care Management Analyst CMO (JR233892)

Montefiore Hudson Valley Collaborative; City of Yonkers (NY); Vor Ort; USD 65.000 - 75.000; Vollzeit

Zusammenfassung

Montefiore Health System is seeking a Care Management Analyst (CMA) to support pediatric and adult populations with complex medical, behavioral health, and social needs. The CMA collaborates with care managers, physicians, and community partners to navigate care, promote self-management, and improve outcomes.

Under supervision of a licensed clinician, the CMA analyzes data from EHRs and other systems, identifies intervention opportunities, and helps implement individualized care plans to enhance

Qualifikationen

• High School Diploma or GED required.
• LPN (Licensed Practical Nurse) with NYS registration required.
• 2 Years work experience in a managed care or health system setting preferred.
• Medical Management experience in a managed health care setting preferred.
• Appropriate training and experience in case management preferred.

Aufgaben

• Develop and support care management programs for pediatric and adult populations with complex needs.
• Collect and integrate clinical, behavioral, psychosocial, and utilization information to identify intervention opportunities.
• Facilitate access to healthcare services and community resources and support individualized care plans.
• Manage designated caseload and support utilization management to reduce avoidable ED visits, admissions, and readmissions.

Kenntnisse

2+ years work experience

Patient engagement

Care coordination

Ausbildung

LPN License (NYS)

High School Diploma or GED

Tools

MS Office

Case/Utilization Management Systems

Data entry

Automatic phone distribution systems

Electronic fax systems

Copier/Scanning

Web-based information systems

Jobbeschreibung

Introduction

To heal, to teach, to discover and to advance the health of the communities we serve.

To learn more about the “Montefiore Difference” – who we are at Montefiore and all that we have to offer our associates, please click here.

Overview

Working under the supervision of a licensed/certified clinical professional, the Care Management Analyst (CMA) supports care management programs serving pediatric and adult populations with complex medical, behavioral health, chronic care, palliative care, care transition, and social determinants of health needs. This highly collaborative role combines patient engagement, care coordination, population health management, and utilization management to help patients navigate the healthcare system, overcome barriers to care, and achieve optimal health outcomes.

Responsibilities

The CMA plays a key role in advancing patient-centered, whole-person care across the continuum of care. Through the collection and integration of clinical, behavioral, psychosocial, and utilization information from patients, caregivers, providers, electronic health records, and other clinical information systems, the CMA develops a comprehensive understanding of patient needs and identifies opportunities for intervention.

Working closely with care managers, physicians, interdisciplinary care teams, and community partners, the CMA facilitates access to healthcare services and community-based resources, supports implementation of individualized care plans, promotes treatment adherence and self-management, and monitors ongoing care management interventions to improve quality, outcomes, and patient experience.

The CMA is responsible for managing a designated caseload and supporting care management and utilization management activities designed to reduce avoidable emergency department visits, hospital admissions and readmissions, improve care coordination and access, address social and clinical barriers to health, and enhance member engagement and satisfaction. Through proactive outreach, data-driven interventions, and timely follow-up, the CMA contributes to improved health outcomes and value-based care performance.

Requirements

• High School Diploma or GED required.

• LPN (Licensed Practical Nurse, with valid NYS registration)

• 2 Years work experience

• Medical Management experience in a managed health care setting preferred.

• Appropriate training and experience in case management preferred.

Equipment Operation:

• MS Office, email, internet

• Experience working within case/utilization management systems, data entry and typing

• Automatic phone distribution systems

• Electronic fax systems

• Copier/scanning machine

• Familiarity with web-based information systems