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Case Manager III (56595)

Professional Management Enterprises
United States, New York, New York
May 07, 2024
Looking for a HealthcareCase Manager III (RN/LMSW/LCSW). Must be bilingual in Spanish and have MLTC, UAS Assessment and NY Medicaid policy experience. The position is remote but may need to conduct minimal field visits. MUST BE LICENSED IN THE STATE OF NY. The work schedule is M-F, 8:30am-5pm EST. Summary: Works with members, providers, and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. Completes clinical assessments of members per regulated timelines and determines who may qualify for case management based on clinical judgment, changes in member's health or psychosocial wellness, and triggers from the assessment. Develops and implements a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals and member's support network to address the member's needs and goals. Maintains ongoing member case load for regular outreach and management. Assesses barriers to care, provides care coordination and assistance to member to address concerns. Required Education \| Experience: Bachelor's degree in Nursing or Master's degree in Social Work. 5-7 years in case management, disease management, managed care or medical or behavioral health settings. Bilingual in English/Spanish Active, unrestricted State Registered LicensedRN/LMSW/LCSW- Licensed in the State of NYin good standing.