SOCIAL CARE MANAGER - CENTRAL NEW YORK

Description At Healthy Alliance, our purpose is to improve health and empower communities facing barriers. Every community has its own needs, affecting the health of those who live, learn, work, and play within them. Our network brings together organizations, big and small, to coordinate and collaborate so that all communities have reliable access to the resources they need. Why? Because every New Yorker deserves the same opportunity to be healthy. Designated as the Social Care Network (SCN) Lead Entity for the Capital Region, Central NY, and North Country under New York’s 1115 Waiver Amendment’s SCN & Health-Related Social Needs (HRSN) Program, we are responsible for ensuring that there is a seamless, consistent end-to-end process for screening, navigation, and the delivery of services – including food, housing, and transportation to thousands of Medicaid Members. Transformative in nature, this novel Program will further sustain our vision of cultivating a world wherein everyone has a fair and just opportunity to be as healthy as possible. As a 2019-2024 Albany Business Review’s Best Places to Work and a 2021-2026 Modern Healthcare’s Best Places to Work in Health Care award recipient, we strive to maintain a culture wherein high-performing, mission-driven team members collectively work toward better health for all. Dedicated to promoting a culture built upon autonomy, mastery, and purpose, we believe our differences in strengths and perspectives play an integral role in propelling us forward, while our core values ground us, serving as the common thread that unites our team. Why You Should Join Healthy Alliance We offer amenities, professional development opportunities, events, and programming that support the interests of our teams while expanding and enriching our culture. Some of the benefits you can expect when you join Healthy Alliance include: Competitive compensation package Comprehensive insurance benefits available the 1st of the month after hire, including but not limited to medical, dental and vision, group short-term disability and life insurance with buy-up options, flexible spending and HSA company-contributed accounts, and more 401K with a company match Unlimited paid time off after 90 days of employment Company-sponsored training and certification opportunities Hybrid work environment and people-first workplace A workplace that values safety, respect, employee engagement, recognition, and diversity Salary range: $52,950-$60,892 per year, commensurate with experience Who You Are The Social Care Manager is the direct point of contact for Members with ongoing HRSNs and is responsible for conducting eligibility assessments for Managed Medicaid Members eligible for enhanced HRSN services, as well as development of Social Care Plans. Location We are looking for someone in Central New York What You’ll Do Manage incoming referrals for enhanced HRSN care management to support successful and timely connections for community members. Provide longitudinal care management for Members receiving one or more enhanced HRSN services. Utilize the Electronic Provider Assisted Claim Entry System/Medicaid Eligibility Verification System (ePACES/MEVS) and other data sources to confirm Medicaid enrollment and HRSN screening status, as well as existing care team management. Conduct and document outreach to community members in alignment with required frequency, modality, and timeframe. Manage Member consent and attestation as required throughout the screening, assessment, and care management process. Conduct HRSN screening using the Accountable Health Communities (AHC) screening tool to assess Member HRSNs. Conduct eligibility assessments to determine Member eligibility for enhanced HRSN services and refer Members to eligible programs and services to include enhanced HRSN services and/or existing federal, state, and local resources. Develop Social Care Plans that include a summary of Member needs, eligibility, and services to which they are referred. Ensure referrals are acted upon by HRSN service providers within required timeframes and redirect referrals as necessary to support service connection. Document progress notes and action taken with each referral, as detailed in the Network Standards and Quality Program. Update the Social Care Plan throughout service provision in collaboration with the Member and service provider to reflect strategies and interventions for meeting identified HRSNs. Monitor and manage eligibility status changes in collaboration with Eligibility Specialists and Enhanced HRSN service providers. Confirm service delivery completion and Member needs have been addressed satisfactorily and support the transition to additional resources. Demonstrate ability to use various technology platforms to ensure successful and timely referral connections are made. Maintain effective communication with internal team members, community members, and partner organizations to ensure overall coordination of care. Collaborate with Performance team to report partner effectiveness and efficiency regarding referral response and service delivery and elevate community member service issues in a timely manner. Regularly use data and data tools to report referral patterns and trends to the Referral Coordination Manager. Share detailed feedback on successes and challenges of the role with the Referral Coordination Manager and continually look for opportunities to enhance and simplify the community member experience. Effectively work in a hybrid work environment. Some local travel may be required for meetings, community events, and other job-related responsibilities. Demonstrate commitment to the values of diversity, equity, and inclusion. Maintain current knowledge and understanding of Medicaid and local transformation, including New York Health Equity Reform (NYHER) 1115 Waiver Amendment, Waiver programs, Triple Aim, and value-based purchasing (VBP). Perform other responsibilities and duties as assigned. How You’ll Contribute Member-Centered Care Coordination and Critical Thinking: Actively listen to Members, apply critical thinking, and independently assess needs to determine appropriate next steps, referrals, and resources. Time Management and Workload Prioritization: Effectively manage multiple referrals, prioritize tasks, meet documentation timelines, and maintain accuracy in a high-volume environment. Workflow Navigation and Process Adherence: Navigate internal workflows confidently, locate information efficiently, apply processes accurately, and adapt to operational changes. Communication and Interpersonal Effectiveness: Communicate clearly and empathetically with Members and teams, remain calm under pressure, and handle escalations professionally. This job description is not designed to cover or contain a comprehensive listing of task activities and/or duties that are required of the employee for this job. Responsibilities and activities may change at any time with or without notice. Requirements What You’ll Need Education Associate degree in health, social services, or related field preferred. Equivalent work experience in a related field may be considered in lieu of degree requirements. Professional work experience Minimum of 5+ years related experience in a clinical, non-profit, or Managed-Care Organization (MCO) environment preferred. Knowledge, Skills, and Abilities Extensive knowledge and understanding of health equity, social drivers of health, and social care data. Excellent communication and presentation skills. Experience using translation services preferred. Ability to build collaborative working relationships with others inside and outside the organization through cooperation, mutual respect and capacity to inspire and motivate others. Thrive working with multiple systems and processes. Extremely detailed-oriented and capable of multitasking. Proven record of hitting key metrics, defining effective data-driven network development strategies, and problem-solving. Proficient computer skills and willingness to learn additional software applications. Demonstrated ability to thrive in a demanding environment. Performs all work in accordance with Healthy Alliance core competencies and values. Additional Job Information This position involves sedentary work that primarily involves sitting/standing, use of typical office equipment such as a computer, laptop, and cell phone. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Equal Opportunity Employer Healthy Alliance is an Equal Opportunity Employer and does not discriminate against any employee or applicant on the basis of age, ancestry, color, family or medical care leave, gender identity or expression, genetic information, marital status, medical condition, national origin, physical or mental disability, political affiliation, protected veteran status, race, religion, sex (including pregnancy), sexual orientation, or any other characteristic protected by applicable laws, regulations and ordinances. We adhere to these principles in all aspects of employment, including recruitment, hiring, training, compensation, promotion, benefits, social and recreational programs, and discipline. If you require reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please direct your inquiries to View email address on click.appcast.io. Privacy Requirement This job function involves potential access/interaction with protected health information. Position will be required to abide by company policies and procedures that support federal, state, and local HIPAA regulations. Any violations will be subject to company policy which includes disciplinary actions up to and including separation of employment. At-Will Statement Healthy Alliance is an At-Will Employer. #J-18808-Ljbffr