Care Manager - DSNP - 100% Remote

Healthfirst; Town of Texas (WI); Remote; USD 71,000 - 107,000; Full time

Job summary

A leading healthcare provider seeks a Care Manager for a fully remote role, specializing in behavioral and physical care management. The role emphasizes member advocacy, dual eligibility plan management, and collaboration across healthcare teams to ensure comprehensive care pathways. Applicants should possess relevant qualifications like an RN or LCSW, along with strong interpersonal skills, particularly in senior care.

Benefits

Medical insurance

Dental insurance

Vision insurance

Life insurance

401k

Qualifications

• Registered Nurse (NYS) or LCSW/LMSW required.
• 3 years experience in mental/behavioral health or addictions.
• PEDS experience preferred for applicable roles.

Responsibilities

• Manage care plans and advocate for beneficiaries.
• Conduct assessments to identify barriers.
• Coordinate with healthcare teams for best outcomes.

Skills

Interpersonal skills

Assessment skills

Fluency in Spanish

Fluency in Korean

Fluency in Mandarin

Fluency in Cantonese

Education

NYS RN

LCSW/LMSW

CASAC certification

Tools

Microsoft Excel

Electronic documentation systems

Job description

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This 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. The role involves applying care management principles to engage members, coordinate healthcare services, provide an excellent member experience, address barriers, and improve health outcomes. The Care Manager is assigned to specific product lines such as CompleteCare, SNP, Medicaid/Medicare, PHSP, HARP, etc.

Duties and Responsibilities

• Responsible for dual eligibility plan management.
• Advocate, inform, and educate beneficiaries on services, self-management techniques, and health benefits.
• Conduct assessments to identify barriers and intervention opportunities.
• Develop care plans aligned with physicians’ treatment plans and recommend interventions.
• Generate referrals to providers, community resources, and other services.
• Liaise between service providers to ensure coordinated care.
• Coordinate with the multidisciplinary healthcare team to ensure person-centered care and maximize outcomes.
• Identify opportunities for alternative care options based on assessments.
• Evaluate service authorizations to ensure alignment with care and treatment plans.
• Document encounters and update care plans as needed.
• Occasional overtime may be required.
• Perform additional duties as assigned.

Minimum Qualifications

• For Medical Care Management: NYS RN or LCSW/LMSW (any state). PEDS positions require 1 year pediatric experience.
• For Behavioral Health Care Management: NYS RN or licensed psychologist, LCSW, LMSW, LMFT, LMHC, LPC (any state). 3 years experience in mental/behavioral health or addictions. PEDS experience preferred.
• 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 adults and cognitively impaired seniors.
• Experience managing member information in digital systems.
• Relevant work experience as a Care Manager.
• Ability to manage large caseloads and work in a fast-paced environment.
• Proficiency with Microsoft Excel and electronic documentation systems.

Hiring Range

• Greater NYC Area (NY, NJ, CT): $81,099 - $116,480
• Other locations: $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
• Industries: Hospitals and Healthcare