Healthfirst
Care Manager, Fluent in English/Fujianese - 100% Remote
Healthfirst, Granite Heights, Wisconsin, United States
Overview
Care Manager, Fluent in English/Fujianese – 100% Remote at Healthfirst. 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 is responsible for applying care management principles when engaging members and addressing coordination of their health care services to provide an excellent member experience, address barriers, and improve their health outcomes. The Care Manager is assigned to a specific product line such as CompleteCare, SNP, Medicaid/Medicare, PHSP, HARP, etc. 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 (doctors, social workers, discharge planners, and community-based service providers) to ensure coordinated care and addressed needs. Coordinates and facilitates with the multi-disciplinary health care team to ensure person-centered care plan goals and maximize 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 and follows up as needed; updates care plans based on member needs. Overtime as necessary. Additional duties as assigned. Minimum Qualifications
For Medical Care Management: NYS RN or LCSW or LMSW (any state) For PEDS positions only: 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 For BH PEDS positions only: 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, along with demonstrated ability to handle rapidly changing situations. Fluency in Fujianese Knowledge and experience with 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 preferably as a Care Manager Demonstrated ability to manage large caseloads and work effectively in a fast-paced environment Proficient with navigating the Internet and multi-tasking with multiple electronic documentation systems Experience using Microsoft Excel with the ability to edit, search, sort/filter and other PHI systems 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 depend on work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision. Healthfirst offers a full range of benefits such as medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (subject to eligibility). Job Details
Employment type: Full-time Job function: Health Care Provider Industries: Hospitals and Health Care
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Care Manager, Fluent in English/Fujianese – 100% Remote at Healthfirst. 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 is responsible for applying care management principles when engaging members and addressing coordination of their health care services to provide an excellent member experience, address barriers, and improve their health outcomes. The Care Manager is assigned to a specific product line such as CompleteCare, SNP, Medicaid/Medicare, PHSP, HARP, etc. 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 (doctors, social workers, discharge planners, and community-based service providers) to ensure coordinated care and addressed needs. Coordinates and facilitates with the multi-disciplinary health care team to ensure person-centered care plan goals and maximize 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 and follows up as needed; updates care plans based on member needs. Overtime as necessary. Additional duties as assigned. Minimum Qualifications
For Medical Care Management: NYS RN or LCSW or LMSW (any state) For PEDS positions only: 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 For BH PEDS positions only: 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, along with demonstrated ability to handle rapidly changing situations. Fluency in Fujianese Knowledge and experience with 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 preferably as a Care Manager Demonstrated ability to manage large caseloads and work effectively in a fast-paced environment Proficient with navigating the Internet and multi-tasking with multiple electronic documentation systems Experience using Microsoft Excel with the ability to edit, search, sort/filter and other PHI systems 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 depend on work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision. Healthfirst offers a full range of benefits such as medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (subject to eligibility). Job Details
Employment type: Full-time Job function: Health Care Provider Industries: Hospitals and Health Care
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