Case Management, Professional, Case Management
Professional, Case Manager
Status: Full-time, Exempt: Yes
This position will utilize the essentials of an integrated case management model that includes assessment, planning, implementation, care coordination, monitoring and advocacy to meet the member’s overall comprehensive health needs. Through collaborative efforts the Case Manager will identify the medical and psycho-social needs of designated members, act as a proactive partner, and provide appropriate education, resources and healthcare coaching telephonically or “face to face”. The principle role of the position is to engage individual members, and communicate with an established interdisciplinary team to create an individualized person centered care plan. In addition, the position will provide guidance in understanding benefit coverage and navigating the health care delivery system. The overall objective is to create solutions to overcome barriers to care and assist the member achieve optimum health and/or improved functional capability through the coordination of quality cost effective care. The Case Manager will also monitor and review cases with the Medical Director to ensure appropriate outcomes. Other duties as assigned by supervisor.
Current New York State Licensure as a Registered Nurse
Bachelor's degree in nursing preferred
Case Management Certification a Plus (ANCC or CCM)
At least 3 years of recent clinical and Case Management experience.
Certification in Case Management required within 24 months after hire.
•Ability to professionally communicate with members, and all interdisciplinary team members.
•Excellent oral and written communication skills
•Demonstrated clinical knowledge including an understanding of population health management and the case management process.
•Detail oriented with strong organizational skills including the ability to manage time wisely to meet established deadlines.
•Ability to work in an energetic team environment.
•Experience with situations requiring strict adherence to confidentiality.
•Ability to solve problems while exhibiting clinical judgment and realistic understanding of the current environment.
•Ability to make independent decisions regarding resource utilization, and quality of care.
•Must demonstrate understanding of clinical and psychosocial issues that may alter treatment or care plan and be able to demonstrate good judgment when dealing with emotionally charged situations
•Strong computer skills including working knowledge of Word, Windows based applications, typing and internet access
- Job Family Medical Management/Clinical
- Pay Type Salary
- Headquarters Office, 625 State Street, Schenectady, New York, United States of America
- Rochester Office, 220 Alexander Street, Rochester, New York, United States of America