Care Manager - Cluster Care

Care Manager - Cluster Care

Responsible for the assessment, reassessment, care planning and coordination of care and services. Includes ongoing monitoring of an appropriate and effective person centered care plan, member education and care management. Regularly communicates with the members PCP and other providers, and integrates the member, caregiver and other provider feedback into the assessment and planning.

Qualifications

• Valid NYS RN License
• 2+ years' experience in Behavioral Health
• Bachelor's Degree

Additional Information

• 100% field work and 100% face-to-face member interaction.
• The candidate will oversee the care of member who will be transitioning to the community.
• He/ She will be assigned to 1-2 transitional homes.
• These homes are located in Westchester, Manhattan, Queens and the Bronx and Brooklyn. The member caseload of about 125. The manager is flexible with the start time, however, most Care Manager get started between 9am and 10am.
• Mileage is reimburse at $.535/mile. Mileage does not start from the candidate's home to the first location. Nor is mileage calculated from the last location to the candidate's home. Mileage begins from the first location to the next location.
• The candidate will have clinical experience with a focus in managed care, including disease or case management. Experience in utilization review, concurrent review and/or risk management a plus.
• Understands and is able to apply principals of Care Management and Person Centered Service Planning.
• Ability to apply Milliman Care Guidelines and other applicable, evidenced-based clinical guidelines. Ability to understand and apply coverage guidelines and benefit limitations. Familiar with clinical needs and disease processes for chronic physical and behavioral illnesses (depression, challenging behaviors, Alzheimer's disease and other disease-related dementias).