Health Home Care Manager (Buffalo, NY / Field-based)

FreedomCare•Buffalo, NY

1d•$24 - $26•Hybrid

About The Position

FreedomCare is a healthcare company founded in 2016, dedicated to empowering patients by allowing them to choose their own caregivers for in-home care. The company operates nationwide and is guided by core values: Here For You, Own It, Do the Right Thing, and Be Positive. They are seeking a Health Home Care Manager to join their Care Management team. This is a field-based role requiring frequent travel to patient homes in Buffalo, New York.

Requirements

Associate's degree is a must
2 years of Care Management experience
Ability to travel in the field to accompany patients to appointments and meet patients in person when needed
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

Nice To Haves

Bachelor's Degree is a plus
Bilingual Spanish strongly preferred
Ability to travel to all 5 boroughs in the NYC area
Access to a vehicle is strongly preferred

Responsibilities

Outreach and engage potentially eligible patients to enroll them in the Health Home Care Management Program.
Collaborate with the patient's care team to complete comprehensive assessments and patient-centered care plans.
Coordinate care based on the care plan.
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 and help them achieve their 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.