Healthfirst
Care Manager, Fluent in English/Fujianese - 100% Remote
Healthfirst, Phila, Pennsylvania, United States
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Care Manager, Fluent in English/Fujianese - 100% Remote
role at
Healthfirst
Overview The Care Manager plans and manages behavioral and/or physical care with members and works collaboratively with them, their supports, providers, and health care team members. The Care Manager applies care management principles when engaging members to coordinate health care services, aiming to provide an excellent member experience, address barriers, and improve health outcomes. The Care Manager is assigned to a specific product line such as CompleteCare, SNP, Medicaid/Medicare, PHSP, HARP, etc.
Duties and Responsibilities
Advocates, informs, and educates beneficiaries on services, self-management techniques, and health benefits.
Conducts assessments to identify barriers and opportunities for intervention.
Develops care plans that align with the physician’s treatment plans and recommends interventions that align with proposed goals.
Generates referrals to providers, community-based resources, and appropriate services to assist in goal achievement and maintenance of successful health outcomes.
Liaises between service providers such as doctors, social workers, discharge planners, and community-based service providers to ensure care is coordinated and needs are addressed.
Coordinates and facilitates with the multi-disciplinary health care team to ensure care plan goals are person-centered and maximize member health outcomes.
Assists in identifying opportunities for alternative care options based on member needs and assessments.
Evaluates service authorizations to ensure alignment with the member’s care and physician treatment plan.
Contributes to corporate goals through ongoing execution of member care plans and goal achievement.
Documents all encounters with providers, members, and vendors in the appropriate system; follows up as needed; updates care plans as appropriate.
Occasional overtime as necessary.
Additional duties as assigned.
Minimum Qualifications
For Medical Care Management:
NYS Registered Nurse (RN) or
LCSW or LMSW (any state)
For Pediatric positions: 1 year of pediatric clinical field experience and/or experience with families and child-serving systems, including child welfare and/or medically fragile/developmentally disabled populations
For Behavioral Health (BH) Care Management:
NYS RN or
LCSW, LMSW, LMFT, LMHC, LPC, licensed psychologist (any state)
3 years of work experience in a mental/behavioral health or addictions setting
BH Pediatric positions: 1 year of pediatric clinical field experience and/or experience with families and child-serving systems, including child welfare and/or medically fragile/developmentally disabled populations
Preferred Qualifications
Strong interpersonal and assessment skills, especially the ability to relate well with seniors, their families, and community care providers, with the ability to handle rapidly changing situations.
Fluency in Fujianese
Knowledge of current community health practices for frail adults and cognitively impaired seniors.
Experience managing member information in a shared network environment using paperless database modules and archival systems.
Experience and knowledge of the relevant product line.
Relevant work experience as a Care Manager preferred.
Demonstrated ability to manage large caseloads in a fast-paced environment.
Proficient with navigating the Internet and multiple electronic documentation systems; able to multi-task.
Experience using Microsoft Excel with the ability to edit, search, sort/filter and other functions related to PHI systems.
Compensation
Hiring Range: Greater New York City Area (NY, NJ, CT residents): $81,099 - $116,480
All Other Locations (within approved locations): $71,594 - $106,080
As a candidate for this position, salary and related elements of compensation will be contingent upon work experience, education, licenses and certifications, and other factors Healthfirst deems pertinent to the hiring decision.
In addition to salary, Healthfirst offers benefits such as medical, dental, vision, life insurance, 401k contributions, and incentive/recognition programs (eligibility requirements apply).
The hiring range is defined as the lowest and highest salaries that Healthfirst in good faith would pay to a new hire, or for a promotion or transfer into this role.
Other
Seniority level: Not Applicable
Employment type: Full-time
Job function: Health Care Provider
Industries: Hospitals and Health Care
Referrals increase your chances of interviewing at Healthfirst. Get notified about new Care Manager jobs in Pennsylvania, United States.
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Care Manager, Fluent in English/Fujianese - 100% Remote
role at
Healthfirst
Overview The Care Manager plans and manages behavioral and/or physical care with members and works collaboratively with them, their supports, providers, and health care team members. The Care Manager applies care management principles when engaging members to coordinate health care services, aiming to provide an excellent member experience, address barriers, and improve health outcomes. The Care Manager is assigned to a specific product line such as CompleteCare, SNP, Medicaid/Medicare, PHSP, HARP, etc.
Duties and Responsibilities
Advocates, informs, and educates beneficiaries on services, self-management techniques, and health benefits.
Conducts assessments to identify barriers and opportunities for intervention.
Develops care plans that align with the physician’s treatment plans and recommends interventions that align with proposed goals.
Generates referrals to providers, community-based resources, and appropriate services to assist in goal achievement and maintenance of successful health outcomes.
Liaises between service providers such as doctors, social workers, discharge planners, and community-based service providers to ensure care is coordinated and needs are addressed.
Coordinates and facilitates with the multi-disciplinary health care team to ensure care plan goals are person-centered and maximize member health outcomes.
Assists in identifying opportunities for alternative care options based on member needs and assessments.
Evaluates service authorizations to ensure alignment with the member’s care and physician treatment plan.
Contributes to corporate goals through ongoing execution of member care plans and goal achievement.
Documents all encounters with providers, members, and vendors in the appropriate system; follows up as needed; updates care plans as appropriate.
Occasional overtime as necessary.
Additional duties as assigned.
Minimum Qualifications
For Medical Care Management:
NYS Registered Nurse (RN) or
LCSW or LMSW (any state)
For Pediatric positions: 1 year of pediatric clinical field experience and/or experience with families and child-serving systems, including child welfare and/or medically fragile/developmentally disabled populations
For Behavioral Health (BH) Care Management:
NYS RN or
LCSW, LMSW, LMFT, LMHC, LPC, licensed psychologist (any state)
3 years of work experience in a mental/behavioral health or addictions setting
BH Pediatric positions: 1 year of pediatric clinical field experience and/or experience with families and child-serving systems, including child welfare and/or medically fragile/developmentally disabled populations
Preferred Qualifications
Strong interpersonal and assessment skills, especially the ability to relate well with seniors, their families, and community care providers, with the ability to handle rapidly changing situations.
Fluency in Fujianese
Knowledge of current community health practices for frail adults and cognitively impaired seniors.
Experience managing member information in a shared network environment using paperless database modules and archival systems.
Experience and knowledge of the relevant product line.
Relevant work experience as a Care Manager preferred.
Demonstrated ability to manage large caseloads in a fast-paced environment.
Proficient with navigating the Internet and multiple electronic documentation systems; able to multi-task.
Experience using Microsoft Excel with the ability to edit, search, sort/filter and other functions related to PHI systems.
Compensation
Hiring Range: Greater New York City Area (NY, NJ, CT residents): $81,099 - $116,480
All Other Locations (within approved locations): $71,594 - $106,080
As a candidate for this position, salary and related elements of compensation will be contingent upon work experience, education, licenses and certifications, and other factors Healthfirst deems pertinent to the hiring decision.
In addition to salary, Healthfirst offers benefits such as medical, dental, vision, life insurance, 401k contributions, and incentive/recognition programs (eligibility requirements apply).
The hiring range is defined as the lowest and highest salaries that Healthfirst in good faith would pay to a new hire, or for a promotion or transfer into this role.
Other
Seniority level: Not Applicable
Employment type: Full-time
Job function: Health Care Provider
Industries: Hospitals and Health Care
Referrals increase your chances of interviewing at Healthfirst. Get notified about new Care Manager jobs in Pennsylvania, United States.
#J-18808-Ljbffr