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Healthfirst Senior Manager Care Management in Home Office, New York

Description

The Senior Manager of Care Management is responsible for the oversight of a complex care management team and ensuring effective and efficient care management is provided to our members to ensure and maintain a high

level of quality care and compliance. This position reports to the Director of Care Management, Integrated Products.

  • Lead and manage the care management team to ensure the best individualized care decisions, adherence to timely assessments and interventions for each member’s changing condition(s).

  • Build a high performing team where clinical, technical and leadership skills are developed and assessed on a regular basis.

  • Enforce guidelines as mandated by CMS and New York State regulations, job aides and HF policies. This includes review of performance audit reports in order to maintain superior and accurate care data for each member in the member’s electronic record.

  • Participates in the Quality Management Program, identifying performance/process improvement opportunities and recommends studies for annual quality plan. Uses reports and data to foster care management

  • Assist with budget planning, preparation and adherence.

  • Additional duties as assigned.

Minimum Qualifications:

  • Associate’s degree in Nursing from an accredited program

  • NYS RN license

Preferred Qualifications:

  • Experience managing a team of employees

  • Experience working as a care manager for a long term care programs such as PACE, MAP or MLTC.

  • Knowledge of Medicare Regulations related to Long Term Care.

  • Experience working and/or managing in a virtual environment.

  • Problem-solving skills that can include emergency situations while communicating instructions and results in a succinct and clear verbal and written manner.

  • Experience interacting with caregivers such as a family member to communicate instructions and explain sensitive issues at an expertise level that can be understood by the client.

  • Experience in an environment using interdisciplinary / integrated model of care management sharing information among team members related to create an individualized comprehensive care plan.

  • Understanding of health plans such as Medicare, Medicaid and/or Managed Long-Term Care Plan (MLTCP).

  • Language preferences - Spanish, Russian, French, Creole, Mandarin, Cantonese.

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, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

If you have a disability under the Americans with Disability Act or a similar law, and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services.

EEO Law Poster and Supplement

REQNUMBER: R005761

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