What are the responsibilities and job description for the Care Management Associate (OB, Case Management) position at MetroPlus Health Plan?
Care Management Associate (OB, Case Management)
Job Ref : 117467
Category : Professional
Department : CASE MANAGEMENT PROGRAM
Location : 50 Water Street, 7th Floor, New York, NY 10004
Job Type : Regular
Employment Type : Full-Time
Hire In Rate : $50,000.00
Salary Range : $50,000.00 - $50,000.00
Empower. Unite. Care.
MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.
About NYC Health Hospitals
MetroPlus Health provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly owned subsidiary of NYC Health Hospitals, the largest public health system in the United States, MetroPlus Health's network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlus Health has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.
Position Overview
Under the direction of the Team Lead and Care Manager, the Care Management Associate (CMA) is a member of a team that provides support to our Medicaid members receiving Personal Care Services (PCS). As an integral team member, the CMA will work in conjunction with the Care Manager to ensure the member receives appropriate and necessary services, ensuring members are connected to care, engage with the member and the member's care team to identify goals and interventions that will improve their health and community resources that will support their well-being to ensure quality outcomes (i.e., reduction in emergency room visits and hospital admissions, improved member satisfaction, closing and reducing Gaps in Care) and cost effectiveness. The CMA will also support the Team Lead with assignments, reports, referrals, and electronic notifications.
Job Description
- Problem-solve members' issues in an independent, resourceful manner
- Perform non-clinical activities for members of varying age, clinical scenario, culture, financial means, social support, and motivation
- Troubleshoots member issues related to transportation, appointments, DME, medication, SDoH
- Ensure members have appointments with their providers
- Engage members / caregivers in a collaborative relationship, empowering them to manage their physical, psychosocial, and environmental health to improve and maintain lifelong well being
- Coordinate required services in accordance with member, caregiver, clinical and non-clinical providers, and care managers when involved
- Advocate for members by assisting them to address challenges, and make informed choices regarding the use of social and other community supports
- Promote communication, both internally and externally to enhance effectiveness of clinical and non-clinical services and overall case management services
- Assist members in understanding mechanics and management of health care and social support networks
- Maintain accurate and complete documentation of required information in compliance with risk management, regulatory and accreditation requirements
- Assist member in research and understanding of benefit and claims information and resolution
- Protect the confidentiality of member information and adheres to all company policies regarding confidentiality
- Employ critical thinking and judgment when dealing with unplanned issues
- Collect and prepare data, statistics, proposals and reports relevant to responsibilities as a Care Management Associate
- Comply with all orientation requirements, annual and other mandatory trainings, organizational and departmental policies and procedures, and actively participate in evaluation process
- Ensures compliance with Federal, State, and City regulations, and is consistent with the Mission, Vision, and Values of the organization
- Performs other appropriate duties and participates in other special projects as assigned by Leadership
Minimum Qualifications
Professional Competencies
MHP50
LI-Hybrid
Salary : $50,000
