Care Manager - DSNP - 100% Remote

Healthfirst; New Jersey; Remote; USD 71,000 - 107,000; Full time

Job summary

A leading healthcare provider is seeking a Care Manager to work 100% remotely. The role involves managing and coordinating care plans for members, collaborating with healthcare teams, and addressing barriers to improve health outcomes. Ideal candidates should have relevant qualifications such as an RN or LCSW and possess strong interpersonal skills.

Benefits

Medical insurance

Dental insurance

Vision insurance

Life insurance

401k

Qualifications

• Pediatric experience preferred for PEDS roles.
• 3+ years experience in mental health or addiction settings required.
• Experience managing large caseloads in a fast-paced environment.

Responsibilities

• Manage dual eligibility plans and coordinate with service providers.
• Develop care plans and advocate for beneficiaries.
• Conduct assessments to identify barriers and intervention opportunities.

Skills

Interpersonal skills

Assessment skills

Fluency in Spanish

Fluency in Korean

Fluency in Mandarin

Fluency in Cantonese

Education

NYS RN or LCSW/LMSW

Credentialed Alcohol and Substance Abuse Counselor

Tools

Microsoft Excel

Job description

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The position is 100% remote. The Care Manager plans and manages behavioral and/or physical care with members, working collaboratively with them, their supports, providers, and healthcare team members. Responsibilities include applying care management principles to engage members, coordinate healthcare services, improve member experience, address barriers, and enhance health outcomes. The Care Manager is assigned to specific product lines such as CompleteCare, SNP, Medicaid/Medicare, PHSP, HARP, etc.

Duties and Responsibilities

• Manage dual eligibility plans.
• Advocate for, inform, and educate beneficiaries on services, self-management, and health benefits.
• Conduct assessments to identify barriers and intervention opportunities.
• Develop care plans aligned with physicians' treatment plans, recommending appropriate interventions.
• Generate referrals to providers, community resources, and other services to support health goals.
• Coordinate with service providers to ensure comprehensive care.
• Facilitate multidisciplinary team collaboration to meet care plan goals.
• Identify alternative care options based on assessments.
• Evaluate service authorizations for alignment with care and treatment plans.
• Document all interactions and update care plans as needed.
• Perform occasional overtime as required.
• Perform additional duties as assigned.

Minimum Qualifications

• For Medical Care Management: NYS RN or LCSW/LMSW (any state); Pediatric experience preferred for PEDS roles.
• For Behavioral Health Care Management: NYS RN or licensed psychologist, LCSW, LMSW, LMFT, LMHC, LPC; 3+ years experience in mental health or addiction settings; Pediatric experience preferred for PEDS roles.
• For CASAC positions: Credentialed Alcohol and Substance Abuse Counselor.

Preferred Qualifications

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

Compensation

The hiring range for Greater NYC residents is $81,099 - $116,480; for other locations within approved areas, $71,594 - $106,080. Salary depends on experience, education, licenses, and certifications. Benefits include medical, dental, vision, life insurance, 401k, and more.

Additional Details

• Employment type: Full-time
• Job function: Healthcare Provider
• Industry: Hospitals and Healthcare

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