Health Home Plus Care Manager

OCO • Oswego, NY

20h • Hybrid

About The Position

Provides case management services to people of all ages with complex health needs, according to OCO Universal Service Delivery methods in diverse locations, including OCO offices, other agency offices, program sites, public places and the homes of consumers. Independently provides service coordination and care management services to eligible individuals. Carries out duties in accordance with Agency and Program policies and procedures.

Requirements

• Must establish and maintain successful professional relationships with community members and agencies.
• Must have the ability to work with vulnerable populations including those with severe and persistent mental health conditions, substance use issues, and complex health needs.
• Must be able to work well with others, be a positive role model, and be a good representative of the Agency.
• Must provide education and support for appropriate problem resolution and living skills.
• Must have good oral and written communication skills and have excellent documentation and reporting skills.
• Must possess skills for complex data entry and have the ability to read and interpret complex information and manipulate data.
• Must have demonstrated ability to work with others in a warm, non-judgmental manner and be a positive role model.
• Must be able to work independently as well as a member of a team.
• Must maintain high confidentiality and exhibit professionalism, good judgment, and flexibility.
• Must be flexible with work schedule to meet the needs of participants and the program
• Must attend staff meetings and training as required.
• Must have acceptable physical and mental health to carry out the position's responsibilities.
• Travel throughout the county is required; must possess a valid NYS Driver's License with a driving record within Agency policy and have access to a reliable vehicle for regular travel and transporting customers.

Nice To Haves

• Bachelor’s degree in Social Work, Nursing (RN), Public Health, Counseling, Psychology, Human Services, or related field — and experience in care coordination/case management.
• Associate degree/certification in a related field plus additional relevant experience
• Any equivalent combination of experience and training is relevant to this position.

Responsibilities

• Provides crisis intervention and comprehensive, non-judgmental, consumer centered services that are strength based, develop assets, and mobile throughout Oswego County with a caseload of approximately 35 members.
• Provides Health Home approved comprehensive care management to Medicaid eligible individuals and ensures timely engagement.
• Supports participants in developing health related care plans based on comprehensive assessments that include identifying medical, behavioral health and other social determinants through standardized tools; maintains accurate and up to date records.
• Coordinates with other services and or health care providers to engage participants, assist in maintaining health related goals that ensure improved health outcomes and follow up as needed.
• Advocates on behalf of consumers with other community providers & provide accompaniment and/or advocacy as needed.
• Follows up on referrals to ensure participants’ needs have been appropriately met.
• Provides or arranges transportation to enable consumers to connect with needed community resources.
• Communicates pertinent information to co-workers, supervisors and community partners, as instructed.
• Completes all documentation as required including electronic records, documents for billable services within required timeframes
• Ensures billing records are complete and submitted per funder and agency guidelines for timely reimbursement
• Oversees caseload distribution to ensure appropriate stratification and maximized billing opportunities
• Acts in a Leadership role, represents the agency to community partners and oversees program specific functions, as assigned.
• Adheres to local, state, federal, and agency regulations, policies, and procedures.
• Attends training, staff meetings, conferences, and seminars, as assigned.
• Ensures compliance with NYSDOH Policies, privacy/HIPAA and all Health Home Program requirements
• Carries out project responsibilities and other program-related tasks as assigned.

Benefits

• Equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, creed, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, marital status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level