Care Manager at Healthfirst coordinating physical and behavioral health care for diverse members. Engaging with clients, developing care plans, and collaborating with healthcare teams to improve outcomes.
Responsibilities
Plans, manages, and coordinates physical and behavioral care
Supports a variety of areas including the Recipient Restriction Program (RRP)
Conducts medical reviews of member usage patterns
Participates in RRP Committee meetings
Advocates and educates beneficiaries on services and self-management techniques
Develops care plans that align with the physician’s treatment plans
Generates referrals to providers and community-based resources
Coordinates care with the multi-disciplinary health care team
Evaluates service authorizations and updates care plans
Requirements
NYS RN
Strong interpersonal and assessment skills
Ability to relate well with seniors and their families
Fluency in Spanish, Korean, Mandarin, or Cantonese
Knowledge and experience with current community health practices for frail adults
Knowledge of InterQual and LOCADTR
Experience managing member information in a shared network environment
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