Children's Health Home Care Manager

The Arc Jefferson St Lawrence•Watertown, NY
•Onsite

About The Position

The Care Manager conducts and schedules assessments, referrals, advocacy and supports, counseling, and education for patients, enrollees, and care team members to help ensure patients receive quality services and meet their healthcare needs without barriers. The role includes outreach and engagement to formally enroll referred individuals in the care management program; conducting assessments; evaluating needs; establishing and maintaining care plans; and maintaining referrals. The Care Manager ensures supports are in place, including peer and family contacts. The position is full-time, 40 hours per week, with a typical Monday–Friday schedule of 8 a.m.–4:30 p.m., flexible to program needs. The role involves frequent travel within the tri-county area and rotating after-hours on-call coverage outside regular working hours, with additional compensation in accordance with organizational policy. The position operates in a professional office environment and has no supervisory responsibility.

Requirements

  • A bachelor's degree with two years of relevant experience, or NYS licensure and registration as a Registered Nurse, or a master's degree with one year of relevant experience.
  • Strong written, verbal, and organizational skills.
  • Computer skills.
  • Authorization to work in the United States.
  • Frequent travel within the tri-county area.

Responsibilities

  • Develop an Interim Plan of Care based on preliminary clinical information and assigned level, identifying immediately required linkages and services using information from referral sources when applicable.
  • Ensure initial linkages are established and maintained.
  • Collaborate with service providers and establish a team communication plan.
  • Monitor goals continuously, ensure the team is communicating, and ensure the care plan complies with health home policies and procedures.
  • Consult with family members and social supports to maintain consistent support.
  • Advocate for additional services and linkages as appropriate.
  • Maintain current care management documentation and information about care management activities in the required health information technology system.
  • Enter and maintain progress notes related to the Plan of Care.
  • Attend quarterly regional meetings for the CNYHHN and participate in monthly conference calls with CNYHHN providers.
  • Engage families in outreach after the agency receives a referral.
  • Ensure compliance with CNYHHN policies and procedures.
  • Attend required CNYHHN and agency online and in-person training.
  • Participate in agency committees as assigned and satisfactorily complete required in-services.
  • Provide rotating after-hours on-call coverage outside regular working hours.
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