Children's Home Health Care Manager

The Salvation Army Eastern Territory•City of Rochester, NY

About The Position

Care Manager provides outreach and enrollment services to individuals presumed to meet eligibility requirements of New York State’s Health Home program. They gather assessments and enter documentation that confirms eligibility and identifies areas requiring supportive services. They work with individuals and service providers to create a comprehensive Plan of Health Care, identify additional service providers as necessary, and coordinate the continuing involvement of individuals and service providers in the execution of the plan. Care Manager documents progress and arranges for eventual transition between health homes as necessary, or from health homes to other levels of service following changes in eligibility. This is a 40 hr/week position (Mon-Fri 7:30 a.m.-4:00 p.m.) May require hours outside of these general hours.

Requirements

Bachelor’s Degree with two years of experience; master’s degree with one year of experience
Relevant experience in serving children and families in child welfare, developmental disabilities, behavioral health, primary health care, or social services
Experience coordinating and participating in team settings
Solid writing and verbal communication
Work effectively and knowledgeably across a broad spectrum of cultural, ethnic, and racial communities
Ability to work in an effective and focused manner when self-directed and beyond immediate oversight
Ability to deliver family-driven, youth-guided services
Requires computer proficiency including word processing skills and the ability to provide culturally competent practice
Must have valid driver’s license that meets The Salvation Army insurance requirements
Must have access to a vehicle to provide home
Perform all duties associated with job responsibilities

Responsibilities

Assesses, engages and enrolls clients into health home program, per NYSDOH and Lead Health Home
Complete home visits with enrolled member at least once/month; at a frequency determined by client need.
Collaboratively complete a yearly assessment of needs, strengths and goals with the member/family and care teams.
Facilitates yearly (minimum) meetings with member's care teams and works within that team to develop a comprehensive Plan of Care.
Provide the following core services to enrolled members: care coordination, comprehensive care management, transitional care, crisis intervention and caregiver/family support (coordinating with care team, making referrals to other providers, ensuring follow up from hospital discharges/ED visits, ensures preventive medical/dental care, etc.)
Document all case activities in an Electronic Health Record, following the NYS guidelines around documentation quality and time frames.
Ensure that monthly billing standards are met for each enrolled member and that a billing questionnaire is submitted within the month that the activity took place.
Participate in mandatory and optional
Participate in weekly supervision
Other duties as assigned