Care Manager, Remote

Lensa; United States; Remote; USD 48,000 - 130,000; Full time

Job summary

A leading healthcare organization seeks a dedicated Care Manager to advocate for patients and develop tailored care plans. The position involves collaborating with multidisciplinary teams to ensure optimal health outcomes and requires relevant qualifications like RN or LCSW. Strong interpersonal and assessment skills are essential, along with experience in managing complex cases and navigating community health resources.

Qualifications

• NYS RN, LCSW or LMSW for Medical Care Management.
• 3 years of experience in behavioral health setting required.

Responsibilities

• Advocates and educates beneficiaries on services.
• Develops care plans aligned with physician treatment.
• Coordinates care with the healthcare team.

Skills

Interpersonal skills

Assessment skills

Knowledge of health practices

Fluency in Spanish

Fluency in Korean

Fluency in Mandarin

Fluency in Cantonese

Education

NYS RN or LCSW or LMSW

Licensed psychologist (any state)

Job description

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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 physicians 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 members 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)
• 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 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
  
  

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

If you have questions about this posting, please contact [e-mail]

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  IT Services and IT Consulting

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