Care Manager, Bilingual Fujianese - 100% Remote

Healthfirst; New York (NY); Hybrid; USD 71,594 - 116,480; Full time

Benefits offered by this job

Medical, dental, and vision coverage

401(k) contributions

Incentive and recognition programs

Job summary

Healthfirst is seeking a Care Manager in New York to oversee behavioral and physical care for members. This role involves collaboration with various health care providers to enhance member outcomes and ensure a seamless experience.

The ideal candidate will have an appropriate nursing or social work license and experience in mental health settings. Salary ranges from $71,594 to $116,480, depending on location, with benefits that include health coverage and retirement plans.

Qualifications

• NYS RN, LCSW, LMSW or equivalent license required.
• 3 years experience in a mental/behavioral health or addictions setting.
• Experience with pediatric populations, if applying for specific roles.

Responsibilities

• Advocates for members and educates them about services.
• Conducts assessments to identify barriers to health.
• Develops care plans aligned with treatment goals.
• Coordinates care with multi-disciplinary health teams.

Skills

Strong interpersonal skills

Assessment skills

Fluency in Fujianese

Knowledge of community health practices

Proficient with electronic documentation systems

Education

NYS RN or LCSW or LMSW

3 years of work in mental/behavioral health

Tools

Microsoft Excel

Job description

Position Overview

The Care Manager plans and manages behavioral and/or physical care with members and works collaboratively with them, their supports, providers, and health care team members. The Care Manager is responsible for applying care management principles when engaging members and addressing coordination of their health care services to provide an excellent member experience, address barriers, and improve their health outcomes. The Care Manager is assigned to a specific product line such as CompleteCare, SNP, Medicaid/Medicare, PHSP, HARP, etc.

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.
• Liaises 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

• For Medical Care Management: NYS RN or LCSW or LMSW (any state).
• For PEDS positions only: 1 year of pediatric clinical field experience and/or experience with families and child serving systems, including child welfare and/or medically fragile/developmentally disabled populations.
• For Behavioral Health (BH) Care Management: NYS RN or LCSW, LMSW, LMFT, LMHC, LPC, licensed psychologist (any state) with 3 years of work experience in a mental/behavioral health or addictions setting.
• For BH PEDS positions only: 1 year of pediatric clinical field experience and/or experience with families and child serving systems, including child welfare and/or medically fragile/developmentally disabled populations.

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 Fujianese.
• 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 using Microsoft Excel with the ability to edit, search, sort/filter and other Microsoft and PHI systems.

Salary and Benefits

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. Benefits include medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401(k) contributions (subject to eligibility requirements).

Equal Opportunity Employer Statement

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.