HARP Care Manager (with additional 10% field differential)

MetroPlusHealth; New York (NY); On-site; USD 85,000 - 95,000; Full time

Job summary

A community-focused healthcare organization is hiring a HARP Care Manager in New York, NY. This role involves assessing and coordinating care for members with complex health needs, ensuring adherence to treatment plans, and generating referrals to appropriate services. Candidates must possess a Master's Degree and have 3-5 years of experience in Behavioral Health, preferably with HARP experience. Strong interpersonal and assessment skills are essential. The position offers a salary range of $85,000 to $95,000, and may include a $10,000 additional field differential.

Qualifications

• 3-5 years of experience in Behavioral Health within managed care settings.
• Field-based Case Management Experience is required.
• Current valid unrestricted NY State License as LCSW, LMSW, or LMHC.

Responsibilities

• Develop and communicate care plans with the member's team.
• Clinically assess members for health needs and generate referrals.
• Coordinate post-discharge aftercare and follow-up appointments.

Skills

Behavioral Health experience

Case Management

Interpersonal skills

Assessment skills

Education

Master's Degree

Tools

Microsoft Office

DCMS

Microsoft Teams

Job description

HARP Care Manager (with up to $10,000 additional field differential)

Join to apply for the HARP Care Manager (with up to $10,000 additional field differential) role at MetroPlusHealth

Base pay range

$85,000.00/yr - $95,000.00/yr

MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.

Position Overview

The HARP Care Manager develops, facilitates, and communicates a plan of care in partnership with the member, his/her assigned Health Home, primary caregiver, the primary and attending physicians, and various Behavioral Health and/or Substance Use Disorder providers. In partnership with these parties, the HARP Care Manager assesses, plans, facilitates, and advocates for options and services to meet a HARP member’s complex health needs through communication and available resources. In addition, the HARP Care Manager is responsible for scheduling aftercare follow-up for members discharging from an acute behavioral health inpatient setting. This position ensures that members have a scheduled appointment in place, completes follow-up and reminder calls to members, and follows up with providers to ensure member’s compliance with aftercare. Most case management activities will be performed in the field via community and facilities outreach.

Work Shifts

9:00 AM - 5:00 PM

Duties & Responsibilities

• Clinically assess members for acute behavioral and physical health needs. Generate referrals to providers, community-based resources, and appropriate services to assist in goal achievement.
• Conduct Utilization Review for designated Case Management members for some diversionary levels of care (CORE/HCBS, ACT).
• Meet with members in their homes, shelters, other residential settings, at community agencies, hospital inpatient units and/or day hospital programs.
• Conduct initial and ongoing Behavioral Health clinical assessments.
• Develop a formal plan of care for all services needed for the HARP member. Notify physicians of any changes in the member’s plan of care.
• Assist members and providers in accessing post-discharge aftercare related appointments. Coordinate with inpatient facility teams to identify appropriate follow-up care for CORE and HARP BH members.
• Outreach to members regarding adherence to 7-day follow-up appointments and offer a 30-day appointment as part of HEDIS measures.
• Mail discharge aftercare letters with a list of referrals to members not reached by phone.
• Collaborate on timely follow up with assigned nurses for clinical updates to plans of care.
• Document IDT care coordination notes between internal MetroPlusHealth staff and external Health Home/CMA workers.
• Review and approve submitted Health Home Plans of Care and ensure that CMAs conduct timely annual assessments. Review CORE/HCBS requests; educate CMA workers about PROS and IOP options for members who opt out of CORE/HCBS.
• Assist providers with achieving pay-for-performance goals and examine the feasibility of Value Based Payment with high-volume providers for HARP.
• Educate providers on medication and treatment compliance while promoting the use of Long Acting Injectables.
• Enlist existing provider network in promoting first episode psychosis treatment.
• Educate providers on alternate treatment services being promoted by Health + Hospitals in lieu of Inpatient Detox and prepare for bi-weekly Interdisciplinary Care Team (ICT) meetings featuring newly enrolled, frequently admitted, high-utilizing at-risk HARP members.
• Oversee the coordination and delivery of comprehensive, quality healthcare and services for all members requiring care management in a cost-effective manner.
• Evaluate housing needs and assist with housing applications, collaborating with MetroPlusHealth internal housing team for supportive assistance.
• Assist members with coordinating services from various settings as appropriate, including facilitating discharge from acute settings and alternate settings.
• Provide care coordination throughout the continuum of care.
• Identify members appropriate for specialty programs to optimize quality of care and quality of life for MetroPlusHealth members.
• Document comprehensively to ensure goals, interventions, and care coordination activities are compliant with professional standards and regulatory guidelines in DCMS (EMR) and other applicable software.
• Contribute to corporate goals through ongoing execution of member care plans and achievement of member goals.
• Performs other appropriate HARP Behavioral Health duties and participates in special projects as assigned, including audit review and preparation, quality improvement, community health education, facility/provider relations, and marketing activities.

Minimum Qualifications

• Master’s Degree required
• Overall, 3-5 years of Behavioral Health (Serious Mental Illness & Substance Use Disorder) experience in a managed care and/or psychiatric hospital inpatient and/or outpatient setting with both case and utilization management
• One-year HARP experience preferred
• Field-based Case Management Experience within the Integrated Collaborative Care Model
• Experience with chronic condition management, particularly Diabetes, HIV, Heart Disease; Pharmacy, Psyckes, E-PACES, HCS (UAS) MAPP, CORE/HCBS, Microsoft Teams knowledge
• Strong interpersonal and assessment skills and the ability to remain calm with challenging members
• Experience with home visits and bedside assessments in inpatient or residential settings
• Medical background and bilingual preferred
• Quality Management liaison experience with hospitals and large providers to address cost and HEDIS/QARR quality performance preferred

Licensure And/or Certification Required

• Current valid unrestricted NY State License as LCSW, LMSW, or LMHC

Professional Competencies

• Integrity and Trust
• Teamwork and Problem-Solving Attitude
• Customer Service First
• Superior Technical Computer skills (Microsoft Office, DCMS, Teams)
• Clear and Concise Written/Oral Communications
• Exceptional Organizational and Communication Skills