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Family and Childrens Association
Mineola, NY, United States
Care Coordinator The Opportunity The Care Coordinator will provide case management, health education, and referrals and follow-up for individuals receiving services in the Family Treatment and Recovery Centers. The Care Coordinator will act as the Health Coordinator of the multi-disciplinary team to educate staff and clients. Responsibilities C
Job Source: Family and Childrens AssociationFountain House
New York, NY, United States
Job Type Full-time Description POSITION SUMMARY Fountain House's Care Management is a Health Home Care Management agency serving individuals living with serious and persistent mental illness. We are the team helping Medicaid recipients to work on person-centered goals and care management to ensure all their medical and psychiatric needs are being
Job Source: Fountain HouseTransitional Services for New York, Inc.
New York, NY, United States
Transitional Services for New York, Inc., not-for profit, is a comprehensive, community-based mental health organization located in New York City. We provide a continuum of rehabilitative services to enrich the lives of those recovering from mental illness and facilitate their transition to increased levels of independence. Transitional Services f
Job Source: Transitional Services for New York, Inc.CINQCARE
New York
Job Description Job Description CINQCARE Care Coordinator Position Description Overview The Care Coordinator reports to the VP of Quality and Risk Adjustment with accountability for providing strategy, judgment, organization, and evidenced-based analysis to influence decisions, and directly to meet CINQCARE requirements. They should embody CINQC
Job Source: CINQCAREBrighton Health Plan Solutions LLC
Westbury, NY, United States
About The Role REMOTE Support Coordinators handle care management, data entry, and communication with various stakeholders in workers' compensation cases. They provide education and issue resolution for MagnaCare network providers and customers, collaborating to resolve disputes. They also maintain knowledge of policies, working with various depar
Job Source: Brighton Health Plan Solutions LLCApicha Community Health Center
New York
Job Description Job Description Our mission at Apicha Community Health Center is to provide high quality, equitable, whole person and culturally responsive care delivered in an inclusive and welcoming manner. Build and expand on our long tradition of care for AAPI, LGBTQ+ and persons living with HIV. We are currently seeking a Care Coordina
Job Source: Apicha Community Health CenterLaSante Health Center
Brooklyn, NY, United States
Lasante Health Center is seeking a Care Coordinator to join our team. The ideal candidate will monitor our patients’ medical treatment and facilitate communication with healthcare providers to guarantee access to high-quality medical care. Responsibilities: Regularly monitor and manage a designated group of patients with chronic medical condition
Job Source: LaSante Health CenterCenters Plan for Healthy Living
Staten Island, NY, United States
UM Care Coordinator 75 Vanderbilt Ave, Staten Island, NY 10304, USA Req #11764 Monday, April 29, 2024 Centers Plan for Healthy Living's goal is to create the ultimate healthcare experience that provides our members, their families, healthcare decision makers, and general caregivers with the guidance and plans they need for healthy living. JOB
Job Source: Centers Plan for Healthy LivingNew York, NY, United States
Amida Care, the largest Medicaid HIV Special Needs Plan in NY, delivers a uniquely effective care model that has become a true benchmark for innovation, engagement and member health outcomes. Our mission is to provide access to comprehensive care and coordinated services that facilitate positive health outcomes and general well-being for our members. This true integrative care model addresses psychosocial, housing, behavioral and medical services directly evolving around the needs of each member.
We are a community of individuals from diverse peoples who work together to actively foster a fair, equitable, inclusive environment where all employees receive an invitation to belong. Visit Amidacareny.org for more information about the Amida Care culture.
We are actively seeking a highly motivated, innovative, and experienced leader to join our team as the Care Coordinator. Compensation will be commensurate with experience.
Position Summary:
This position serves as an integral part of her/his assigned Integrated Care Team (ICT) and is responsible for coordination of services related to the delivery of medical benefits that ensure members' complex medical, behavioral, pharmaceutical, and psychosocial needs are met within the established benefit policies and guidelines for the treatment and evaluation of members of a specialized needs plan. The Care Coordinator must have strong critical thinking skills to provide clinical oversight to the team and clinical case reviews.
Responsibilities:
Participate in regularly scheduled ICT Meetings. Ensure Amida Care's Integrated Care Model of Care is operationalized within the team structure and that members' complex, multi-disciplinary service needs are met.
Perform clinical oversight of case review, employing critical thinking skills and presenting cases to medical directors and other clinicians.
Coordinate access to behavioral healthcare including review of all HCBS (Home and Community-Based Service) plans of care and complete necessary written clinical documentation for response to providers, overseeing and logging all transactions.
Perform daily review of inpatient census to ensure members are receiving care and services in accordance with established clinical guidelines and in the most appropriate care setting. Follow up with members and providers when a need is identified that will support improved health outcomes for behavioral and physical health.
Communicate with members of the healthcare team to ensure members are receiving services and care in accordance with established clinical guidelines and the Plan's benefit package; review clinical documentation, including laboratory values, to ensure members are receiving appropriate care and implement strategies to address unmet needs as appropriate. Ensure completion of documented care coordination within the Amida Care authorized operating systems.
Perform daily review of inpatient Census to ensure members are receiving care and services in accordance with established clinical guidelines and in the most appropriate care setting. Follow up with members and providers when a need is identified and complete post-discharge calls.
Provide direction and support to staff to ensure timely collection of data, ongoing provider and member outreach and documentation of outreach activities and outcomes.
Coordinate members' access to other services such as home health care, Medical Home, durable medical equipment, hospice care, pharmaceutical, vision, transportation and family planning.
Conduct Utilization Management determinations in accordance with Article 49- Utilization Review. Review clinical documentation, claims/utilization data to ensure members are receiving appropriate care and implement strategies to address unmet needs as appropriate.
Review and assist in the resolution of member grievances within required regulatory timeframes.
Conduct member/provider education, including but not limited to prevention, health promotion, providing appropriate level of care/services specific to enrollee's health status, Plan benefits, Utilization Review processes, etc.
Ensure collection and review of required documentation such as HIV verification and ICT weekly reports.
Amida Care is Diversity, Equity and Inclusion employer committed to full inclusion and elimination of discrimination in all its forms. We strive to develop, promote and sustain a culture that values equity and leverages diversity and inclusiveness in all that we do.
EDUCATION REQUIRED
NYS Licensed Practical Nurse
EXPERIENCES AND/OR SKILLS REQUIRED
Three (3) years managed care experience.
Two (2) years' experience in setting treating physical and behavioral health.
Two (2) years' HIV/AIDS or serious chronic illness care experience.
Healthcare and staff leadership experience preferred.
Demonstrated knowledge of Article 49- Utilization Review process.
Strong knowledge of Microsoft Office (Access, Word and Excel).
Demonstrate understanding and sensitivity to multi-cultural values, beliefs, and attitudes of both internal and external contacts.
Demonstrate appropriate behaviors in accordance with the organization's vision, mission, and values.
Care Coordinator jobs in New York, NY, United States
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