Want to be a part of an amazing organization? An organization that makes a difference in the lives of individuals each and every day?
Monroe Plan for Medical Care is a not-for-profit health care services organization that has been meeting the needs of our members in the Greater Buffalo, Rochester, Syracuse, Albany and Binghamton Regions for over 50 years. Monroe Plan provides health home services and other critical health care services to individuals covered by Medicaid, Child Health Plus and the Essential Plan.
Following our mission and vision to improve the health status of individuals and families, Monroe Plan's innovative clinical care management programs are structured to meet the unique needs of members, providers, health care organizations and the communities we serve. Monroe Plan has consistently been recognized as a national leader in the "safety net" area, with a proven track record of improving health outcomes and reducing disparities by supporting a health care delivery system that ensures the availability of high quality medical care for all.
Medical Case Manager
A current NYS Professional Nursing licensed is required.
Grade 307
This position requires occasional travel throughout Erie County and Monroe County.
This is a full time position, working from home.
The minimum and maximum annual salary that Monroe Plan believes in good faith to be accurate for this position at the time of this posting are $60,949 - $78,362. In addition to your salary, Monroe Plan offers a comprehensive benefits package (all benefits are subject to eligibility requirements) and non-monetary perks. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
POSITION SUMMARY
Provide case management to adult members with high risk or complex medical and psycho-social problems through community and home based visits, and telephonic support. Provide linkage to appropriate care services, and communicate with providers in order to reduce health disparities and improve health care outcomes. Provide oversight of member support activities performed by outreach representatives and social work staff on a case specific basis. Develop and implement targeted initiatives based on member preference and disease states that promote improved health care outcomes and quality of life.
ESSENTIAL JOB DUTIES/FUNCTIONS
1. Provides Case Management Services. Under the direction of the Manager or Clinical Coordinator, the Case Manager will:
* Provide case management to members with high risk or complex medical and psycho-social problems through community and home based visits and telephonic support.
* Provide linkage to appropriate community resources, referral to appropriate care services, and communicate with providers in order to reduce health disparities and improve health care outcomes.
* Act as an advocate for members to assure access and service delivery across the continuum of care and community resources.
* Develop and implement targeted initiatives based on knowledge and expertise in clinical practice and disease states that promote improved health care outcomes and quality of life.
* Meet regulatory and agency policy and procedures related to the practice and documentation of case management activities.
* Demonstrate strong interpersonal skills in order to handle difficult situations in a professional and courteous manner.
* Handle confidential information in accordance with HIPAA, state and federal confidentiality rules.
OTHER FUNCTIONS AND RESPONSIBILITIES
* Identify opportunities to improve processes and services. Share with Manager and Clinical Services Leadership issues that are obstacles to providing great service.
* Perform other duties as assigned.
MINIMUM REQUIREMENTS/LICENSES/CERTIFICATIONS
* A current NYS Professional Nursing License is required.
* A minimum of 2 years’ experience in medical case management and 2 years' recent acute care and/or community health nursing with knowledge of community resources, health care services, treatment planning and discharge planning.
* Effective and diplomatic oral communication skills. Good listening skills.
* Sound reasoning and problem solving skills.
* Strong computer skills.
* Ability to read, understand and follow written policies and procedures.
* Ability to learn new skills.
* Ability to interact with individuals with diverse cultural and religious customs.
* Must have a NYS driver’s license and car for community travel.
* Specialized Case Managers have additional minimum requirements based on specialty area.
PREFERRED QUALIFICATIONS
* Experience in the insurance industry. Managed Medicaid experience a plus.
* Experience in Case Management delivery.
PHI MINIMUM NECESSARY USE: This staff position PHI access will be determined based on Minimum Necessary standards. The Minimum Necessary Grid can be found on the Human Resources and Compliance Web pages.
This job description is only a summary of the typical functions of the job, not an exhaustive or comprehensive list of all possible job responsibilities, tasks and duties. Additional responsibilities, tasks and duties may be assigned as necessary.
Monroe Plan for Medical Care is an Equal Opportunity Employer.
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