Care Management Coordinator (Queens)

Northwell Health; Manhasset (NY); Sur place; USD 55 000 - 85 000; Plein temps

Résumé du poste

Northwell Health is seeking a Care Management specialist to coordinate services for patients and caregivers within Health Home Plus for defined populations with serious mental illness. You will support primary care teams, manage high-risk patient panels, and facilitate care coordination across hospitals, PCPs, and community resources.

The role emphasizes patient-centered care planning, outreach across clinics, homes, and communities, and collaboration with multidisciplinary teams to improve

Qualifications

• High School Diploma or equivalent required.
• 1-3 years of relevant experience, required.
• Bachelor's or Master's degree in relevant field strongly preferred.
• A CASAC credential with two years of experience; OR a BA/BS with relevant experience in Health Home care management serving SMI/SED population is highly preferred.
• NYS Driver's License strongly preferred.

Responsabilités

• Uses patient-centered motivational interviewing techniques to build rapport and help patients improve their health.
• Supports the primary care team by providing panel management to reduce loss to follow-up and non-compliance in care.
• Acts as a liaison between hospitals, primary care providers, specialists, and community resources for patient-centered care coordination.
• Identifies and tracks high-risk populations and those due for preventive or chronic care services.
• Identifies and tracks patients discharged from inpatient or ED settings.
• Uses team-based communication to close the loop on referrals, follow-ups, and outstanding care plan items; conducts outreach in clinics, homes, and communities.

Connaissances

Motivational interviewing

Care coordination

Patient-centered communication

Team-based communication

Formation

High School Diploma or equivalent

Bachelor's degree

Master's degree

CASAC credential

Two years health home experience

NYS Driver's License

Description du poste

Job Description

Coordinates and participates in activities related to Care Management services to family members and caregivers. Health Home Plus is an intensive Health Home care management service established for defined populations with SMI (severe mental illness) who are enrolled in HHSA.

Job Responsibility

• Utilizes patient-centered motivational interviewing techniques to build rapport and help patients improve their health.
• Supports the primary care team by providing panel management to decrease the number of patients lost to care, non-compliant in follow up care or disconnected from primary care. Participates in the development, maintenance, and adjustment of individualized care plans for high-risk patients that address both medical and social barriers to accessing care.
• Acts as a professional liaison between hospitals, primary care providers, specialists, and community resources on behalf of patients to ensure patient-centered care coordination.
• Identifies and tracks special populations, including high-risk patients and other populations due for preventive or chronic care services.
• Identifies and tracks patients discharged from the inpatient service or the emergency department.
• Uses team-based communication strategies to close the loop on referrals, hospital follow-ups and any outstanding items identified in the patient's care plan. Performs outreach activities in primary care sites, homes, hospitals, and neighborhoods.

Job Qualification

• High School Diploma or equivalent required.
• 1-3 years of relevant experience, required.
• Bachelor's or Master's degree in relevant field strongly preferred.
• A Credentialed Alcoholism and Substance Abuse Counselor (CASAC) and two (2) years of experience; OR A Bachelor’s degree or higher in ANY field with either: three (3) years of experience, or two (2) years of experience as a Health Home care manager serving the SMI or SED population, highly preferred.
• NYS Driver's License strongly preferred.
• Location: Queens

*Additional Salary Detail
The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future.When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).