Home
/
Comprehensive
/
Bilingual Spanish RN/SW Care Manager - 100% Remote
Bilingual Spanish RN/SW Care Manager - 100% Remote-November 2024
Home Office
Nov 28, 2024
ABOUT HEALTHFIRST
As New York’s largest not-for-profit health insurer, Healthfirst offers high-quality, market-leading products to nearly 1.8 million members.
1,001 - 5,000 employees
Healthcare, Insurance
VIEW COMPANY PROFILE >>
About Bilingual Spanish RN/SW Care Manager - 100% Remote

  The Care Manager plans and manages behavioral and/or physical care with members and their beneficiaries and works with clinicians and health care team members. The Care Manager facilitates care and medical attention and addresses identified member needs across the continuum of care. The Care Manager is responsible for applying care management principles when engaging members and addressing coordination of the member’s health care services. The Care Manager is assigned to a specific product line such as FIDA, CompleteCare, SNP, Medicaid/Medicare, PHSP, HARP, etc. *Depending on one’s residence and line of business, the Care Manager may be expected to make home, nursing home, and other related sites visits around downstate New York.

  Duties/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 and other resources to assist in goal achievement.

  Collaborates with provider doctors, social workers, discharge planners, and community based service providers to coordinate care accordingly.

  Coordinates and facilitates with the multi-disciplinary health care team as necessary in order to ensure care plan goals are achieved and maximize member outcomes.

  Assists in identifying opportunities for alternative care options based on member needs and assessments.

  Evaluates service authorizations to ensure alignment and execution of the member’s care and physician treatment plan.

  Contributes to corporate goals through ongoing execution of member care plans and member goal achievement.

  Documents all encounters with providers, members, and vendors in the appropriate system in accordance with internal and established documentation procedures; follows up as needed; and updates care plans based on member needs, as appropriate.

  Occasional overtime as necessary.

  Additional duties as assigned.

  Minimum Qualifications:

  NYS RN or

  LCSW, LMSW, LMFT, LMHC, LPC, licensed psychologist (any state)

  For CASAC positions only: Credentialed Alcohol and Substance Abuse Counselor

  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

  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 crisis situations.

  Fluency in Spanish, Korean, Mandarin, or Cantonese.

  Knowledge and experience with the current community health practices for the frail adult population and cognitive impaired seniors.

  Knowledge of InterQual and LOCADTR.

  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 effectively work in a fast-paced environment

  Proficient with simultaneously 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 Microsoft and PHI systems

  WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

  If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to [email protected] or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services.

  EEO Law Poster and Supplement (http://www.dol.gov/agencies/ofccp/posters)

  All hiring and recruitment at Healthfirst is transacted with a valid “@healthfirst.org” email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. If you receive a communication from a sender whose domain is not @healthfirst.org, or not one of our recruitment partners, please be aware that those communications are not coming from or authorized by Healthfirst. Healthfirst will never ask you for money during the recruitment or onboarding process.

Comments
Welcome to zdrecruit comments! Please keep conversations courteous and on-topic. To fosterproductive and respectful conversations, you may see comments from our Community Managers.
Sign up to post
Sort by
Show More Comments
SIMILAR JOBS
NPD Engineering Co-op
NPD Engineering Co-op Date: Jan 23, 2024 Location: Cincinnati, OH, US Company: Teleflex Expected Travel : None Requisition ID :9717 About Teleflex Incorporated Teleflex is a global provider of clinic
Business Relationship Manager I- Officer
Join the team providing financial solutions to over 3 million small businesses nationwide at one of the world's most innovative banks. If you are customer focused, enjoy building relationships and pr
Flex Merchandiser
Flex Merchandiser Date Posted: 01/02/2024 Apply Employee Type:Part Time Location:Springtown, TX Pay Rate:10 Date Posted: 01/02/2024 Job ID: 121245 Job Description Retail Merchandisers Needed! Earn $1
Medical Technologist
Description $5,000 SIGN ON BONUS AND RELOCATION ASSISTANCE INCLUDED HCA Florida JFK North Hospital 2201 45th St West Palm Beach, FL 33407 We have been serving the healthcare needs of Palm Beach Count
Cost Accountant
Cost Accountant Location: North Andover, MA Employment Type: Full-Time, Permanent, Onsite Salary: $100,000 - $120,000 Responsibilities: Assist with month-end, quarter-end, and year-end closing for th
New Grad RN, Orthopedics - full time, nights
At Central Maine Healthcare our team members are committed to providing exceptional care and experiences for our community and for each other every day. The Transition to Practice Nurse Residency Pro
Wellness Worker-West Region
About: Labcorp is a leading provider of biometric testing services, population health and comprehensive workforce wellness strategies. These services are performed by a network of Labcorp personnel l
Leasing Consultant
We Care. We Deliver. Our purpose is to create communities our residents are proud to call home. We currently own or manage over 85,000 units in North America and continue to grow. B e ll Partners , h
Infusion RN - Per Diem
At Central Maine Healthcare our team members are committed to providing exceptional care and experiences for our community and for each other every day. Position Summary: The RN, Oncology provides di
Summer Intern Systems Engineering
About the RoleThe General Dynamics Land Systems Summer 2024 Internship Program provides an opportunity for students looking to start or continue the transition from academia into industry. Our three-
Copyright 2023-2024 - www.zdrecruit.com All Rights Reserved