Health care manager job description

The Health Home Plus Care Manager is responsible for Health Home Plus qualified individuals in the following categories: HIV/AIDS, SMI, and Adults. The Case Manager is responsible for case retention activities including enrolling new clients to maintain a caseload at 15 or as determined by DOH. Adjustments to case load will be made according to DOH recommendations. Provide follow-up services according to the standards or care and tracking for their caseload.
Responsibilities
· Be individually responsible for client retention.
· Maintain full responsibility for caseload including assessments, HARP Eligibility assessments, Care Plans, HML's, timely documentation; Conduct home visits and fieldwork on an ongoing basis and in accordance with the DOH guidance on minimum standards for Health Home Plus; Conduct diligent search activities for missing clients, Case conference with and obtain necessary records from all primary agencies that are involved with the clients.
· Provide appropriate referrals and ensure follow-up by monitoring the quality of services, verifying and ensuring client participation; Provide education and supportive counseling to ensure that clients understand and follow up with services to which they are referred
· Ensure that ALL needed services are addressed /delivered for each client monthly without limiting services to a single provision of care; services should be prioritized and specific to clients' needs and not prescriptive.
· Ensure every client on their case load is CONTACTED AND BILLED FOR each month and provide weekly tracking of billing to their supervisor.
· Document the billable and non-billable services in the required software within 24 hours. Be specific and include comprehensive notes for every service provided.
· Track accurate and up-to-date case lists including closures in a timely manner
· Engage referrals within 24 hours of receipt; Complete enrollments in a timely manner, track, and submit immediately to the Care Manager supervisor assigned
· Participate in the agency quality improvement and professional development programs, attending internal and external training courses and committees
· All aspects of the care management process in order to ensure timely and accurate completion of all care management activities
· Ensure that documentation is completed in a timely manner including progress notes written within 24 hours.
· Attend weekly care management meetings facilitated by the Care Manager supervisor
· Work with your supervisor to ensure that your caseload is covered when you are out of the office.
· Available for evening and weekend telephone crisis intervention and coverage for other staff as needed
· If bilingual, translate for non-English speaking clients
· Additional duties as assigned
Qualifications
· Master's Degree in health or human services related field and 2 years of experience or a Bachelor's Degree in health or human services related field and 4 years' experience;
Or a wavier provided through DOH.
· Experience working with HIV/AIDS; mental illness; or those returning to independent living from institutional care; Interest in chronic illnesses, substance abuse and homelessness.
· Awareness of and sensitivity to cultural and socioeconomic characteristics of populations served. Ability to work collaboratively with other professionals.
· Ability to set appropriate limits with clients and co-workers.
· Excellent writing and oral communication skills. Good management and organizational skills.
· Basic computer skills required.
· Able to work 35 hours per week, Monday through Friday during normal business hours, or as needed to carry out the job responsibilities.

Who We Are
Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.

We enjoy the important work we do every day in service to our members, partners, colleagues and communities.

Job Summary
The Senior Products(SP) Care Management department seeks a dynamic and motivated behavioral health clinician to support the medical and psychosocial needs of the members we serve. The Behavioral Health Care Manager will directly interface with members of the primary care team, members, and their caregivers in identifying risk factors, conducting assessments, and developing and implementing care plans. This role is the corner stone of assuring the most appropriate behavioral health and social determinants of health care needs are met for our most complex members. S/he will also be a member of the SP Multidisciplinary Team to design and implement programs to support the needs of the SP population. Comfort level in working with older adults in the community and in their homes is a must and experience with addressing challenging behavioral health, serious mental illness and social care issues is required.

Key Responsibilities/Duties - what you will be doing
Assesses the member's psychosocial needs and collaborate with team members and health care providers to develop a plan of care to improve, maintain or support optimal wellness within the context of the member's mental illness, medical condition and entitled benefits. Utilizes solution-focused , task centered treatment, behavior modification and motivational interviewing for improvement in member clinical outcomes and self-management skills Care management involves supporting members and their caregivers through telephonic and face to face interventions when warranted. It also entails collaborating with primary care physicians and specialists to ensure appropriate support and management of medical/behavioral health symptoms. The position does not include providing long term therapy.Collaborates with team members to develop individualized discharge and home care plans for high risk or complex members, incorporating into the plan of care efficient, cost effective interventions, in the most appropriate setting.Serves as a bridge for the member during and following an inpatient psychiatric stay in order to advocate for proper utilization of services and a safe discharge plan back to the community.Facilitates communication with behavioral health providers and inpatient/ outpatient services, ASAPs, PCP offices, VNAs, community partners and state agencies.Communicates and consults with the members of the SP clinical teams in understanding the social determinants of health and its impact on member's health status, behavior and outcomes. Communicate and collaborate with member's social support system, i.e. family, caregivers and significant others as needed.Communicates and consults with members of the SP Care Management team, Tufts Health Plan's Behavioral Health Department, as well as other cross functional areas to recommend and coordinate care for complex member issues.Participates in meetings/committees/workgroups around program development, quality initiatives and business plans as needed.Demonstrates the ability to accurately document information that reflects and supports communications and decisions. Examples of expected documentation include notes, letters, clinical reviews and communication with care managers, medical group clinicians, and other interdepartmental stakeholders.Serve as resource expert to care management team regarding Behavioral and Social Determinants of Health issues. Provides guidance and expert knowledge on accessing community resources and state, federal and other entitlement/benefit programs.

Qualifications - what you need to perform the job
A Master's degree in Social Work or Mental Health Counseling is required. New Hampshire current license in good standing as a LICSW or LMHC preferred OR Current New Hampshire LICSW (Licensed Independent Clinical Social Worker), or LCSW with eligibility within 2 years for LICSWMinimum three to five years of experience in behavioral health care management, medical social work, serious mental illness, PACE program, or COA/ASAP setting. Geriatric expertise preferred.Work cooperatively as a team member across multiple levels within the organization Demonstrate initiative in achieving individual, team, and organizational goals and objectives Must be able to prioritize work and develop strategies for adapting to constantly changing priorities and urgencies.Regard for confidential data and adherence to corporate compliance policy Demonstrate cultural competency and sensitivity Demonstrate the ability to work autonomously Experience with Motivational Interviewing and/or Health CoachingUnderstanding of evidence based behavioral health treatment Comfort with End of Life and Goals of Care discussions Experience or background with serious mental illness and substance abuse

Working Conditions and Additional Requirements
Ability to travel as needed to member's homes, hospitals, skilled nursing facilities, PCP office practices and other sites where patients receive care.

#LI-MB1#LI-Hybrid

Commitment to Diversity, Equity & Inclusion
Point32Health is committed to making diversity, equity, and inclusion part of everything we do-from product design to the workforce driving that innovation. Our DEI strategy is deeply connected to our core values and will evolve as the changing nature of work shifts. Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented and dynamic talent. We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

COVID Policy
Please note: As of January 18, 2022, all employees - including remote employees - must be fully vaccinated. This position will require the successful candidate to show proof of full vaccination against COVID-19. Point32Health is an equal opportunity employer, and will consider reasonable accommodation to those individuals who are unable to be vaccinated consistent with federal, state, and local law.

These positions offer competitive pay/benefit package, a sign-on bonus, access to a company vehicle, tuition/loan assistance, free access to the Wellness Center and more!

The Health Home Care Manager provides supportive care management, utilizing the process of care coordination, for persons who are identified as high users of services and as having problems accessing medical, mental health, social, psychosocial, educational, financial and other necessary services that have been identified in a written plan of care.
THIS POSITION IS ELIGIBLE FOR A SIGN-ON BONUS!

STATUS: Full Time (40 Hours)
LOCATION: St. Mary's Campus/Community Based
*Potential to work from home 1 day a week based on performance and productivity*
DEPARTMENT: Behavioral Health - Care Management
SCHEDULE: Monday - Friday, 40 Hour Day Shift

ATTRIBUTES
Bachelor's Degree required Two years of experience working within the community preferred Strong analytical, computer, and communication skills

RESPONSIBILITIES
Coordination. Responsible for the overall creation, management and coordination across all continuums, of the enrollee's care plan which will include medical/behavioral and social service needs and goals.Documentation. All necessary documentation must be completed within established timeframes. Effectively perform and document progressive community outreach with assigned cases and move to enrolled status as appropriate.Caseloads. Caseloads will consist of patients meeting HHCM eligibility with a mixed-acuity rating.

EDUCATION:
AS (Required)

LICENSES / CERTIFICATIONS:
NYS DL - valid New York State Driver's License - New York State Department of Motor Vehicles (NYSDMV), QHP - Qualified Health Professional - NYS Office of Alcoholism and Substance Abuse Services (OASAS)

PHYSICAL REQUIREMENTS:
S - Sedentary Work - Exerting up to 10 pounds of force occasionally Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

Any physical requirements reported by a prospective employee and/or employee's physician or delegate will be considered for accommodations.

Rochester Regional Health is an Equal Opportunity/Affirmative Action Employer.Minority/Female/Disability/Veterans by a prospective employee and/or employee's Physician or delegate will be considered for accommodations.