Care Manager, English and Bengali Speaker

Job not on LinkedIn

September 6

Apply Now
Logo of Healthfirst

Healthfirst

Healthcare Insurance • Finance • Medicare

Healthfirst is a health insurance provider dedicated to helping New Yorkers access affordable health coverage for individuals and families. With over 30 years of experience, Healthfirst offers a range of plans including Medicaid managed care, Medicare Advantage, long-term care, and essential health plans. The company focuses on providing quality healthcare options, comprehensive benefits, and support to ensure members can maintain their health and well-being.

1001 - 5000 employees

Founded 1993

⚕️ Healthcare Insurance

💸 Finance

📋 Description

• Plans and manages behavioral and/or physical care with members and works collaboratively with them, their supports, providers, and health care team members • Applies care management principles when engaging members and addressing coordination of their health care services • Assigned to a specific product line such as CompleteCare, SNP, Medicaid/Medicare, PHSP, HARP, etc. • 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 • Liaises between service providers to ensure care is coordinated and care needs are adequately addressed • Coordinates and facilitates with the multi-disciplinary health care team to ensure person-centered care plan goals • 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 • Documents all encounters with providers, members, and vendors in the appropriate system and updates care plans as needed • Contributes to corporate goals through ongoing execution of member care plans and member goal achievement • Occasional overtime as necessary • Additional duties as assigned

🎯 Requirements

• NYS RN or LCSW or LMSW (any state) for Medical Care Management • For Behavioral Health Care Management: NYS RN or LCSW, LMSW, LMFT, LMHC, LPC, licensed psychologist (any state) • 3 years of work experience in a mental/behavioral health or addictions setting (for BH Care Management) • For PEDS positions: 1 year of pediatric clinical field experience and/or experience with families and child serving systems • Fluency in Bengali • Knowledge and experience with the current community health practices for the frail adult population and cognitive impaired seniors • 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

🏖️ Benefits

• medical, dental and vision coverage • incentive and recognition programs • life insurance • 401k contributions • competitive compensation and benefits package

Apply Now

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