Care Manager

Healthfirst; Pennsylvania; Remote; USD 71,000 - 107,000; Full time

Job summary

A leading healthcare organization is seeking a Care Manager to plan and manage behavioral and physical care for members. This fully remote role involves advocating for members, conducting assessments, and developing care plans to improve health outcomes. The ideal candidate will have a NYS RN license and strong interpersonal skills, with experience in managing member information and coordinating care.

Benefits

Medical insurance

Dental insurance

Vision insurance

Incentive programs

Life insurance

401k

Qualifications

• NYS RN license required.
• Strong interpersonal and assessment skills, especially with seniors.
• Experience managing member information in digital systems.

Responsibilities

• Advocate and educate beneficiaries on services and self-management techniques.
• Conduct assessments to identify barriers and develop care plans.
• Coordinate with the multidisciplinary healthcare team for person-centered care.

Skills

Interpersonal skills

Assessment skills

Fluency in Spanish

Fluency in Korean

Fluency in Mandarin

Fluency in Cantonese

Knowledge of community health practices

Experience managing member information

Ability to manage large caseloads

Proficiency with Internet navigation

Experience with electronic documentation systems

Experience with Microsoft Excel

Education

NYS RN license

Job description

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The Complex Care Manager plans and manages behavioral and/or physical care and works collaboratively with members and their healthcare team across the continuum of care. This role supports areas including chronic disease management, Hospice/Palliative care, Transitions of Care, and medically complex members. The Complex Care Manager applies care management principles to engage members, coordinate healthcare services, provide an excellent member experience, address barriers, close care gaps, and improve health outcomes.

This position is 100% Remote.

Duties And Responsibilities

1. Advocate, inform, and educate beneficiaries on services, self-management techniques, and health benefits.
2. Conduct assessments to identify barriers and opportunities for intervention.
3. Develop care plans aligned with physicians’ treatment plans and recommend interventions to meet goals.
4. Generate referrals to providers, community resources, and services to support health outcomes.
5. Liaise between service providers to ensure coordinated care and address needs.
6. Coordinate with the multidisciplinary healthcare team to ensure person-centered care and maximize outcomes.
7. Identify opportunities for alternative care options based on assessments.
8. Evaluate service authorizations to ensure alignment with care plans.
9. Contribute to corporate goals through ongoing care plan execution and member goal achievement.
10. Document encounters and update care plans in accordance with procedures.
11. Occasional overtime as necessary.
12. Additional duties as assigned.

Minimum Qualifications

• NYS RN license.

Preferred Qualifications

• Strong interpersonal and assessment skills, especially with seniors, families, and community providers.
• Fluency in Spanish, Korean, Mandarin, or Cantonese.
• Knowledge of community health practices for frail adults and cognitively impaired seniors.
• Experience managing member information in digital systems.
• Relevant work experience as a Care Manager.
• Ability to manage large caseloads in a fast-paced environment.
• Proficiency with Internet navigation and multiple electronic documentation systems.
• Experience with Microsoft Excel and PHI systems.

Hiring Range

• Greater NYC Area (NY, NJ, CT): $81,099 - $116,480
• Other locations within approved areas: $71,594 - $106,080

Compensation includes benefits such as medical, dental, vision, incentive programs, life insurance, and 401k, subject to eligibility.