Healthfirst

The Senior Manager of Care Management is responsible for the oversight of a complex care management team and ensuring effective and efficient care management is provided to our members to ensure and maintain a high level of quality care and compliance.

Duties/Responsibilities:

• Lead and manage the care management team to ensure the best individualized care decisions, adherence to timely assessments and interventions for each member’s changing condition(s)
• Build a high performing team where clinical, technical and leadership skills are developed and assessed on a regular basis
• Enforce guidelines as mandated by CMS and New York State regulations, job aides and HF policies. This includes review of performance audit reports in order to maintain superior and accurate care data for each member in the member’s electronic record.
• Participate in the Quality Management Program, identifying performance/process improvement opportunities and recommend studies for annual quality plan.
• Uses reports and data to foster care management
• Assist with budget planning, preparation and adherence
• Additional duties as assigned

Minimum Qualifications:

• Associate’s degree from an accredited institution
• NYS RN, LCSW, LMSW, LMFT, LMHC, LPC, licensed psychologist (any state) or other relevant clinical license
• Leadership experience in managing, coaching, and developing employees
• Demonstrated ability to build and foster effective relationships
• Working experience in a fast-paced environment overseeing multiple tasks while supporting a team
• Proven track record of exercising independent thinking, problem solving and achieving quotas/goals

Preferred Qualifications:

• Bachelor’s degree
• Experience working as a care manager for long term care programs such as MAP or MLTC
• Knowledge of Medicare Regulations related to Long Term Care
• Experience working and/or managing in a virtual environment
• Problem-solving skills that can include emergency situations while communicating instructions and results in a succinct and clear verbal and written manner
• Experience interacting with caregivers such as a family member to communicate instructions and explain sensitive issues at an expertise level that can be understood by the client
• Experience in an environment using interdisciplinary / integrated model of care management sharing information among team members related to create an individualized comprehensive care plan
• Understanding of health plans such as Medicare, Medicaid and/or Managed Long-Term Care Plan (MLTCP)
• Language preferences - Spanish, Russian, French, Creole, Mandarin, Cantonese

Hiring Range*:

• Greater New York City Area (NY, NJ, CT residents): $119,900 - $183,430

• All Other Locations (within approved locations): $102,600 - $156,655

As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.

In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.

*The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. HF Management Services, LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race, color, creed, religion, sex, national origin, sexual orientation, pregnancy, age, disability, genetic information, domestic violence victim status, gender and/or gender identity or expression, military status, veteran status, citizenship or immigration status, height and weight, familial status, marital status, or unemployment status, as well as any other legally protected basis. HF Management Services, LLC shall not discriminate against any disabled employee or applicant in regard to any position for which the employee or applicant is otherwise qualified.