Remote Care Manager, Complex Disease Management

EmblemHealth, Inc.; New York (NY); Remoto; USD 68.000 - 119.000; Tempo pieno

Descrizione del lavoro

EmblemHealth is seeking a Care Manager to join our NCQA Complex Disease Management program. The role supports high-risk members through a multi-disciplinary care approach, including telephonic and in-home assessments, care planning, and coordinating with physicians, facilities and social resources to improve outcomes.

You will work within a remote/NY framework, coordinating with care teams to ensure safe, timely and cost-effective care, while maintaining member-centered focus in diverse

Competenze

• Active and unrestricted RN license required in NY state.
• CCM certification preferred.
• 4–6+ years of clinical experience (Required).
• Organization/prioritization ability; and the ability to effectively manage a caseload of highly complex members (Required).
• Experience in case management/care coordination, managed care, and/or utilization management (Preferred).
• Computer proficiency: MS Office (Word, Excel, Powerpoint, Outlook); mobile technology (Required).
• System user experience in a highly automated environment (Required).
• Strong cross-group collaboration, teamwork, problem solving, and decision-making (Required).

Mansioni

• Assess and evaluate the needs of our most complex members, coordinating with a multi-disciplinary team to identify gaps in care.
• Identify goals, strategies and interventions including referrals and health education.
• Develop, communicate and evaluate medical management strategies and interventions with the care team.
• Engage with the member and family as appropriate.
• Coordinate with PCPs and care team to set attainable goals.
• Ensure documentation in the EMR and compliance with regulations.

Conoscenze

RN license NY

CCM certification

Clinical experience 4–6+ years

Organization/prioritization

MS Office proficiency

Care management/case coordination

Flexible schedule availability

Bilingual (preferred)

Strumenti

EMR systems

Descrizione del lavoro

EmblemHealth is seeking a Care Manager to join our NCQA Complex Disease Management program. The role supports high-risk members through a multi-disciplinary care approach, including telephonic and in-home assessments, care planning, and coordinating with physicians, facilities and social resources to improve outcomes.

You will work within a remote/NY framework, coordinating with care teams to ensure safe, timely and cost-effective care, while maintaining member-centered focus in diverse