Care Manager II - Health Home (Albany)

Position Summary Elm & Oak Health is hiring Care Managers in the Albany and Capital Region. The role focuses on providing care management services to members eligible for Health Home services, including comprehensive assessments, development of person‑centered care plans, coordination of services across the community, and maintaining thorough documentation. Candidate Requirements Must be willing to travel throughout the Albany/Capital Region. Previous experience working with adults is required. Grade 207: full‑time position, working from home. Annual salary range: $46,948 – $57,380. The company is committed to ensuring equal pay opportunities regardless of gender, race, or other protected categories. Essential Job Duties and Functions 50% Care Management Receive referrals for Health Home services and contact referrers within the required timeframe. Schedule face‑to‑face intake appointments. Conduct bio‑psycho‑social assessments for adults and/or children using NYS and agency‑approved processes. Build therapeutic relationships with members using person‑centered interventions. Coordinate services with health and community providers. Develop Person‑Centered Plans of Care with the member and providers. Disseminate plan information to all involved parties. Interview referrals and families for data collection and education. Recommend service changes or continuations as needed. Maintain monthly telephonic contact and in‑person visits at least quarterly; contact frequency may increase with member acuity. Seek consultation for complex needs. Demonstrate cultural sensitivity and responsiveness. Travel for home visits and community activities. Adhere to Elm & Oak Health professional boundaries and protocols. 30% Documentation Complete all required documentation clearly, concisely, and on time. Demonstrate competency in software platforms within 3 months of training. Complete mandatory assessments (Health Home hub, Health Home authorization, HML) within regulatory timeframes. Document Person‑Centered Care Plans collaboratively. Review and update assessments as mandated by regulations. Maintain thorough documentation for member care activities, at least monthly. Document care management, coaching activities, and terminations electronically. 15% Collaboration Participate in multidisciplinary Care Management teams. Facilitate member‑focused meetings with providers and significant others. Engage in inter‑agency teams and community activities. Support cross‑coverage within Elm & Oak Health staff. Collaborate with Health Home staff on member needs. Manage conflict and promote positive outcomes. Assist in locating members through home visits. Attend and participate in in‑service training. 10% Communication Present professionally to support therapeutic relationships. Provide feedback to providers regarding progress and barriers. Demonstrate active listening to support engagement. Share program information with members and providers as needed. Position Limitations Cannot perform tasks governed by license or registration (diagnosis, medication, treatment). Cannot transport active Monroe Plan members. Cannot provide hands‑on care. Minimum Requirements / Licenses / Certifications Master’s degree in Social Work, Psychology, Nursing, Rehabilitation, Education, OT, PT, Recreation, Counseling, Community Mental Health, Child & Family Studies, Sociology, Speech & Hearing, or related field AND 1 year of direct service experience with Serious Mental Illness, developmental disabilities, alcoholism or substance abuse, or children with SED. Bachelor’s degree in the same fields AND 2 years of direct service experience with the above populations. Credentialed Alcoholism and Substance Abuse Counselor (CASAC) with 2 years of direct service experience with the above populations. Any field with 3 years of direct service experience with the above populations, OR 2 years as a Health Home Care Manager for SMI or SED members. Demonstrated respect for diversity and confidentiality. Teamwork and organizational skills. Strong oral and written communication. Computer literacy. NYC driver’s license and reliable transportation for daily member home visits. Preferred: Previous experience as a Health Home Care Manager. PHI Minimum Necessary Use This staff position’s PHI access will be determined based on Minimum Necessary standards. The Minimum Necessary Grid can be found on the Human Resources and Compliance Web pages. This job description is only a summary of the typical functions of the job, not an exhaustive or comprehensive list of all possible responsibilities, tasks, and duties. Additional responsibilities, tasks and duties may be assigned as necessary. Elm & Oak Health is an Equal Opportunity Employer. #J-18808-Ljbffr Monroe Plan for Medical Care