Care Manager- Health Home

Care Manager Responsibilities

• Perform all enrollment activities as required by DOH and the lead health home. Activities to include but are not limited to; perform outreach contacts, obtain all required signatures on consents, and assist in obtaining supporting documentation

• Conduct initial and updated comprehensive assessments.

• For HARP enrolled individuals, completes HARP eligibility assessment

• Responsible for the creation and management of the member’s Plan of Care (POC) or HARP Plan f Care (if applicable)

• Coordination of care and services between all providers and community resources

• Make referrals to services/additional resources and assist the member in following through with services or appointments

• Meet all monthly billing requirements for each member

• Ensures all required documentation is entered into the electronic health record (EHR). All documentation should meet standards set forth by DOH, the Lead Health Home, as well as the organization’s best practices

• Act as an advocate for the member in a number of settings (school (if applicable), within the home or community, while interacting with different providers or attempting to link member with additional services or resources)

• Assist in educating the member/caregiver/supports on the members diagnosis or condition as well as their needs/strengths/ and goals

• Assists the member in obtaining and/or maintaining public benefits including but not limited to: Medicaid, Cash Assistance Eligibility, Social Security, Supplemental Nutrition Assistance Program, Housing, Legal Services, Employment

• Coordinate and conduct Interdisciplinary Team Meetings in order to facilitate creation of the Plan of Care in addition to coordination of services

• Assist with all coordination of services and benefits in the event of a hospitalization or admission to any facility/residence. Coordinate discharge from any hospital/facility and assist with transfers to another CMA or program should it be necessary in order to ensure continuity of care

QUALIFICATIONS

• Minimum of a bachelor’s degree (or the equivalent experience/expertise) and experience working with populations with complex medical, mental health and psychosocial needs.

• ***** Language Russian, Mandarin, Bengali or Spanish is a Plus *****

***** Pay based on Experience *****