Health Home Care Manager (Brooklyn & Queens, NY / Field-based)

FreedomCare•New York, NY

7d•$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. With a mission extending across the U.S., FreedomCare emphasizes core values of service, ownership, integrity, and positivity. The company is seeking a Health Home Care Manager to join its Care Management team. This role is field-based and requires frequent travel to patient homes in Queens and Brooklyn, New York.

Requirements

Associate's degree is a must.
2 years of Care Management experience.
Must be able to travel to a minimum of 2 boroughs - Brooklyn and Queens.
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 for the Health Home Care Management Program and obtain necessary consents.
Collaborate with patients' care teams to complete comprehensive assessments and develop patient-centered care plans.
Coordinate care based on the established 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 to help them achieve their care plan goals.
Facilitate referrals, address access issues, connect patients to local resources, and develop 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.