Care Manager Social Worker
New York, NY
$85k/year
Full-time
Hybrid
1 month ago
About the role
Marketing Statement
MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth 's network includes over 27,000 primary care providers, specialists and participating clinics. For more than 40 years, MetroPlusHealth has been committed to building strong relationships with its members and providers.
Position Overview
The primary goal of the Care Manager is to optimize members’ health care and delivery of care experience with expected cost savings due to improved quality of care. This is accomplished through engagement and understanding of the member’s needs, environment, providers, support system and optimization of services available to them. The Care Manager is expected to assess and evaluate members’ needs, and be a creative, efficient, and resourceful problem solver. The Care Manager is monitored and assessed based on value added to improved health status of members. That includes, but not limited to their disease management physical and behavioral, medication adherence, and utilization of emergency services, hospitalizations, and avoidable complications. The Care Manager’s primary role is to support members in need and problem solve issues in a beneficial manner for the member and Plan. The support is comprehensive and includes clinical, social, financial, environmental and safety aspects.
Duties & Responsibilities
and motivation
and environmental health to improve and maintain lifelong well being
concepts of cultural sensitivity and privacy practices
limitations/barriers using verbal and nonverbal techniques
adherence), home safety, etc.
unnecessary hospitalizations, and appropriately referring to community supports
clinical status and treatment options
Minimum Qualifications
Professional Competencies
#MPH50
Department Preferences
How To Apply
If you wish to apply for this position, please apply online by clicking the "Apply for Job" button.
MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth 's network includes over 27,000 primary care providers, specialists and participating clinics. For more than 40 years, MetroPlusHealth has been committed to building strong relationships with its members and providers.
Position Overview
The primary goal of the Care Manager is to optimize members’ health care and delivery of care experience with expected cost savings due to improved quality of care. This is accomplished through engagement and understanding of the member’s needs, environment, providers, support system and optimization of services available to them. The Care Manager is expected to assess and evaluate members’ needs, and be a creative, efficient, and resourceful problem solver. The Care Manager is monitored and assessed based on value added to improved health status of members. That includes, but not limited to their disease management physical and behavioral, medication adherence, and utilization of emergency services, hospitalizations, and avoidable complications. The Care Manager’s primary role is to support members in need and problem solve issues in a beneficial manner for the member and Plan. The support is comprehensive and includes clinical, social, financial, environmental and safety aspects.
Duties & Responsibilities
- Problem solves member’s problems and needs: clinical, psychosocial, financial, environmental
- Provide services to members of varying age, clinical scenario, culture, financial means, social support,
and motivation
- Engage members in a collaborative relationship, empowering them to manage their physical, psychosocial
and environmental health to improve and maintain lifelong well being
- Assess risks and gaps in care
- Maximize member’s access to available resources
- Prepare member-oriented plan of care with member, caregivers, and health care providers, integrating
concepts of cultural sensitivity and privacy practices
- Communicate plan of care to Primary Care Physician initially and no less than monthly with updates
- Ensure member caregiver understanding as it relates to language barriers, stress reaction or cognitive
limitations/barriers using verbal and nonverbal techniques
- Train member on relevant chronic diseases, preventive care, medication management (medication
adherence), home safety, etc.
- Provide Complex care management including but not limited to; insuring access to care, reducing
unnecessary hospitalizations, and appropriately referring to community supports
- Advocate for members by assisting them to address challenges, and make informed choices regarding
clinical status and treatment options
- Develop collaborative relationships with clinical providers and facility staff
- Employ critical thinking and judgment when dealing with unplanned issues
- Ability to use data as a tool in tracking and trending outcomes and clinical information
- Maintain accurate, comprehensive, and current clinical and non-clinical documents
- Comply with all orientation requirements, annual and other mandatory trainings, organizational and departmental policies, and procedures, and actively participate in evaluation process.
- Maintain professional competencies as a Care Manager
- Other duties as assigned by Team Lead and Manager.
Minimum Qualifications
- Master’s Degree required
- Minimum 3 years’ prior experience in Case Management in a health care and/or Managed Care setting strongly preferred
- Proficiency with computers navigating in multiple systems and web-based applications
- Ability to proficiently read and interpret medical records, claims data, pharmacy and lab reports, and prescriptions required
- Ability to travel within the MetroPlusHealth service area making home visits to members, facility visits to clinical providers, and visits to community, faith, and other social service-based agencies
- Ability to work closely with member and caregiver
- A valid license and current registration to practice as a Licensed Master Social Worker (LMSW) or Licensed Clinical Social Worker (LCSW) issued by the New York State Education Department (NYSED).
Professional Competencies
- Integrity and Trust
- Customer Focus
- Functional/Technical Skills
- Written/Oral Communications
- Confident, autonomous, solution driven, detail oriented, high standards of excellence, nonjudgmental, diplomatic, resourceful, intuitive, dedicated, resilient and proactive
- Strong verbal and written communication skills including motivational coaching, influencing and negotiation abilities
- Time management and organizational skills
- Strong problem-solving skills
- Ability to prioritize and manage changing priorities under pressure
- Must know how to use Microsoft Office applications including Word, Excel, and PowerPoint and Outlook.
- Ability to form effective working relationships with a range of individuals
#MPH50
Department Preferences
How To Apply
If you wish to apply for this position, please apply online by clicking the "Apply for Job" button.
Skills
OtherHospitals and Health Care