Case Manager, Health Homes (Rochester, NY / Field Based) Sign on Bonus $500.00

FreedomCare•Rochester, NY

2d•$24 - $26•Hybrid

About The Position

FreedomCare is a healthcare company dedicated to revolutionizing the home care industry since 2016, empowering patients to choose their caregivers for in-home care across the U.S. The company operates with core values of service, empathy, ownership, integrity, and a positive attitude. This role is for a Case Manager on the Care Management team in upstate NY, specifically in Rochester, NY, requiring frequent travel to patients' homes within Rochester and surrounding Monroe County areas. The Case Manager will outreach to eligible patients, enroll them in the Health Home Care Management Program, and collaborate with care teams to complete assessments and patient-centered care plans. They will coordinate care based on these plans.

Requirements

1+ year of health homes, HARP or case management experience (required)
Strong working knowledge of local community resources
Demonstrated ability to work with data reporting, documentation, and outcomes
Strong communication and assessment skills
Ability to relate to patients, their families, and community care providers
Ability to handle rapidly changing crisis situations
Ability to manage high volume caseloads
Able to express empathy and compassion for the underserved
Experience navigating several data management systems, such as Salesforce
Bachelor's degree is required

Nice To Haves

Bilingual Spanish, strongly preferred
Master's degree is a plus
3+ years of Health Homes experience
3+ years of HARP experience

Responsibilities

Screen for Health Home functional scale eligibility.
Conduct initial Health Homes assessments and reassessments of patient needs, including medical, mental health, substance use, financial, housing, and additional support needs.
Collaborate with medical providers and patients to develop, implement, and coordinate Health Homes compliant care plans for patients with chronic diseases.
Document care plan outcomes.
Provide direct service to a caseload of chronically ill patients.
Help patients achieve care plan goals by facilitating referrals, addressing access issues, connecting them to local resources, and developing relationships with healthcare providers.
Coordinate patient services and care with pharmacies, insurance companies, hospital discharge planning, family caregivers, and other providers.
Provide crisis intervention when needed.
Conduct home visits and maintain patient contact.
Document all services in accordance with Health Homes standards.
Maintain patient confidentiality at all times.