Care Manager

Healthfirst, Inc.; New Jersey; Remote; USD 71,000 - 117,000; Full time

Job summary

Healthfirst, Inc. is seeking a Complex Care Manager to plan and manage both behavioral and physical care for members. This fully remote role involves coordinating with healthcare teams, developing care plans to improve health outcomes, and providing high-quality member interactions. Candidates must possess a NYS RN license and demonstrate strong assessment and interpersonal skills. The role offers a competitive salary range and benefits package, including medical, dental, and retirement options.

Benefits

Medical coverage

Dental coverage

Vision coverage

Incentive programs

401k contributions

Qualifications

• Must have a NYS RN License.
• Strong interpersonal and assessment skills required.
• Experience managing large caseloads in a fast-paced environment is preferred.

Responsibilities

• Advocates and educates beneficiaries on services and self-management.
• Develops care plans aligned with treatment goals.
• Coordinates care among multi-disciplinary healthcare teams.

Skills

Assessment skills

Fluency in Spanish

Fluency in Korean

Fluency in Mandarin

Fluency in Cantonese

Interpersonal skills

Knowledge of community health practices

Multi-tasking

Education

NYS RN License

Tools

Microsoft Excel

Paperless database systems

Job description

The Complex Care Manager plans and manages behavioral and/or physical care and works collaboratively with the members and their health care team across the continuum of care. This role will support a wide variety of areas including chronic disease management, Hospice/Palliative care, Transitions of Care and medically complex members. The Complex Care Manager is responsible for applying care management principles when engaging members and addressing coordination of their health care services by providing an excellent member experience, addressing barriers, addressing care gaps, and improving health outcomes.

**This position is 100% Remote

Duties and Responsibilities:

• Advocates, informs, and educates beneficiaries on services, self-management techniques, and health benefits.
• Conducts assessments to identify barriers and opportunities for intervention.
• Develops care plans that align with the physician’s treatment plans and recommends interventions that align with proposed goals.
• Generates referrals to providers, community-based resources, and appropriate services and other resources to assist in goal achievement and maintenance of successful health outcomes.
• Liaise between service providers such as doctors, social workers, discharge planners, and community-based service providers to ensure care is coordinated and care needs are adequately addressed.
• Coordinates and facilitates with the multi-disciplinary health care team as necessary to ensure care plan goals and treatment is person-centered and maximizes member health outcomes.
• Assists in identifying opportunities for alternative care options based on member needs and assessments.
• Evaluates service authorizations to ensure alignment and execution of the member’s care and physician treatment plan.
• Contributes to corporate goals through ongoing execution of member care plans and member goal achievement.
• Documents 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

Preferred Qualifications:

• Strong interpersonal and assessment skills, especially the ability to relate well with seniors, their families, and community care providers, along with demonstrated ability to handle rapidly changing situations.
• Fluency in Spanish, Korean, Mandarin, or Cantonese.
• Knowledge and experience with the current community health practices for the frail adult population and cognitive impaired seniors.
• Experience managing member information in a shared network environment using paperless database modules and archival systems.
• Experience and knowledge of the relevant product line
• Relevant work experience preferably as a Care Manager
• Demonstrated ability to manage large caseloads and effectively work in a fast-paced environment
• Proficient with simultaneously navigating the Internet and multi-tasking with multiple electronic documentation systems
• Experience usingMicrosoft Excel with the ability to edit, search, sort/filter and other Microsoft and PHI systems

Hiring Range*:

Greater New York City Area (NY, NJ, CT residents): $81,099 - $116,480

All Other Locations (within approved locations): $71,594 - $106,080

As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.

In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.

*The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.

WE ARE AN EQUAL OPPORTUNITY EMPLOYER.HF Management Services, LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race, color, creed, religion, sex, national origin, sexual orientation, pregnancy, age, disability, genetic information, domestic violence victim status, gender and/or gender identity or expression, military status, veteran status, citizenship or immigration status, height and weight, familial status, marital status, or unemployment status, as well as any other legally protected basis. HF Management Services, LLC shall not discriminate against any disabled employee or applicant in regard to any position for which the employee or applicant is otherwise qualified.

If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to [e-mail] or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within HF Management Services, LLC will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with HF Management Services, LLC. Know Your Rights