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Care Manager New

Rochester, NY

Details

Hiring Company

iCircle Care Website

Positions Available

Full Time

No recruiters please


Position Description

OVERVIEW:

Care Management is a collaborative process that includes assessing physical, social and environmental factors that affect the lives of iCircle Care members. The Care Manager implements an appropriate quality and cost-effective plan that utilizes all resources available to meet those needs. The Care manager utilizes evidence-based health strategies to prevent hospitalization and inappropriate utilization of emergency room visits. The process is cyclical in several phases: assessing, stratifying, planning, implementing/coordinating care and reassessing/evaluating. The Care Manager assists the member in reaching his/her optimum level of wellness, self-care management, and functional capabilities.

RESPONSIBILITIES:

  • Oversee caseload of managed care members
  • Review and evaluate the member’s assessment and UAS information
  • Develop comprehensive service plans
  • Make referrals to appropriate health and community resources in timely manner
  • Review and authorize request for services according to workflows and timeframes
  • Maintain clear, effective communication with member continually, including monthly calls
  • Educate members and caregivers on covered services and benefits
  • Evaluate member in his/her residence on an as needed basis
  • Promote healthy living and injury prevention for members
  • Evaluate available clinical data and notes, including assessments
  • Evaluate member’s response to interventions and makes modifications as necessary
  • Collaborate with interdisciplinary team

ESSENTIAL ACADEMIC AND EXPERIENCE REQUIREMENTS:

  • New York State Licensed Registered Nurse, Bachelor’s degree preferred OR Licensed Master’s Social Worker
  • Minimum five years in healthcare related field, with 2 years as a care manager in managed care environment or community health

iCircle Care is Equal Opportunity/Affirmative Action Employer Minorities/Female/Disabilities/Veteran.


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