About the role

  • Case Manager responsible for member well-being and preventing hospital admissions. Conduct assessments, develop care plans, and coordinate healthcare services for patients.

Responsibilities

  • responsible for helping members achieve a level of well-being, to avoid preventative hospital admissions or readmissions through the administration of quality improvement functions
  • perform telephonic outreach to members, physicians, or other care givers to develop a plan of care for the member who needs CM services
  • perform case management functions using a member-centric, collaborative process to optimize the wellness and functional capability of members
  • adhere to regulatory and compliance requirements, adhere to department productivity and quality metrics
  • conduct comprehensive assessments of the member’s health and psychosocial needs
  • identify cases that would benefit from alternative care through assessment and evaluation of the patient’s needs
  • document the patient’s plan of care in a timely manner

Requirements

  • Registered Nurse (RN) with active, current, unrestricted NYS license
  • licensed master social worker (LMSW)
  • master’s in social work (MSW)
  • licensed dietician with case management experience required
  • Case Management Certification (CCM) required
  • Two (2) years of case management or clinical experience in acute medical/surgical/critical care or ambulatory setting required
  • Proficient computer and Windows skills required, including MS Office
  • Previous clinical experience in a managed care setting as a case/care manager preferred
  • Clinical knowledge of the health and social needs of the population served
  • Ability to identify barriers to a successful case management path
  • Excellent critical thinking and time management skills
  • Excellent written, verbal, and interpersonal communication skills with ability to provide exceptional customer service to external and internal customers to include telephonic interviewing of members; motivational interviewing skills a plus
  • Transferable knowledge, skill, and ability to complete job duties independently and proficiently
  • Flexibility in work schedules and assignments required. Proven examples of displaying the IH values: Passionate, Caring, Respectful, Trustworthy, Collaborative and Accountable.

Benefits

  • full range of benefits
  • generous paid time off
  • scorecard incentive

Job title

Case Manager

Job type

Experience level

JuniorMid level

Salary

$34 - $38 per hour

Degree requirement

Professional Certificate

Location requirements

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