MLTC Case Manager

Cassena Care Bronx, NY TBD
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Hillside CHHA is actively seeking a MLTC Care Manager to join our dynamic team of professionals! 

Job Summary: Care Manager plans and manages patient care with members, their families or significant others, and coordinates with the PCP and all members of the health care team to facilitate the patient's care across continuum of care episodes. The ideal candidate assesses skilled services needs and oversees service authorizations, creates care plans, and coordinates services throughout the continuum of care for high-risk populations.

Job type: full time, work from home (after full orientation) 

Duties and Responsibilities may include but are not limited to:

  • Collaborates with members/families, doctors, Certified Home Health Care Agencies (CHHA) and other service providers
  • Assesses skilled service needs for Managed Care Long-Term (MLTC) members
  • Follows up on calls triggered by changes in meds, diagnosis or events such as ER visits, falls etc.
  • Maintains on-going telephonic communication with members and caregivers
  • Reviews the six month UAS reassessment and follows up as needed.
  • Completes person center care plan (PCSP) and makes changes in the plan of care based upon findings
  • Coordinates with transition team (acute to home, home to skilled nursing facility (SNF), home to hospital and acute to SNF)
  • Conducts managed long-term care quality measure planning and implements evidence based clinical pathways.
  • Performs additional duties as assigned.

 

Job Qualifications:

  • Manageable caseload
  • MLTC Case management experience preferred
  • Work experience as a NYS licensed RN working in a home care environment or as a staff nurse in an acute, sub-acute or long term care (LTC) setting or managed-long term care (MLTCP). Open to recent graduates who are interested in Managed Care
  • Basic Microsoft Word, Excel and electronic medical records database skills
  • Requires very accurate typing skills and interact through electronic documentation using electronic PHI.
  • Excellent written communication and the ability to document grammatically correct notes.
  • Understanding of and sensitivity to cultural differences and needs of the community are essential.


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