Senior Care Management Navigator (Bilingual Spanish Speaking)

Visiting Nurse Service of New York d/b/a VNS Health • New York, NY

11d • $25 - $32

About The Position

Provides education, client advocacy, evaluation, and feedback about clients/enrollees caseload. Evaluates clients'/enrollees eligibility for other programs and benefits. Alerts team members when follow-up is required and ensures efficient and successful access and linkage to the full array of services with the goal of client's successful completion of the care plan. Works under moderate supervision.

Requirements

• License and current registration to practice as a Licensed Social Worker in New York State preferred
• Bachelor's Degree in Healthcare related field required
• Minimum two years experience in care management, community health, social service, or medical practice required
• Effective oral/written/interpersonal communication skills required
• Proficiency in MS Word, Excel and Teams required
• Bilingual skills may be required as determined by operational needs

Responsibilities

• Responsible for reviewing rosters and meeting with team members to identify clients that require complex and routine follow-up and assistance.
• Maintains expertise knowledge on product(s) and organization structure. Acts as a resource to member and client.
• Reviews care plan with the client/enrollee and care management team; notifies and assists the care management team of any immediate needs and risk factors and makes referrals to arrange services to address such needs.
• Motivates and supports client to participate in their individualized care plan by using motivational interviewing techniques and skills to address medical and psycho-social health.
• Provides outreach support via phone to clients/enrollees to follow up on their self-care, medication fills/refills, care plan engagement/adherence scheduled visits, and test results received from providers.
• Reinforces education provided by client’s/enrollee’s medical providers related to the management of the chronic disease or conditions specified in their care plan; helps educate clients/enrollees about conditions including but not limited to, self-care/condition management, program features, benefits, and admission requirements.
• Provides health coaching and support to assigned clients/enrollees from initiation into the program to completion. Works with the care management team to discuss clients’/enrollee’s progress in plan and goals for completion. Prepares detailed, accurate, and timely case notes and utilizes care management platform as required to note client/enrollee progress and updates.
• Provides information and assistance through advocacy and education to client/enrollee/family/formal and informal caregivers on availability and eligibility of entitlements and community-based services. Assists with client/enrollee navigation of health system.
• Works collaboratively with team members to provide outreach and follow up with resistant enrollees with overdue screenings or upcoming appointments and /or who have been non-compliant with necessary treatment appointments. Remind them and schedules doctors/specialists appointments and transportation as necessary.
• Participates in initial and ongoing training to maintain mastery level of knowledge related to Community-Based Resources and new internal programs.
• Protects the confidentiality of member or client information and adheres to company policies regarding confidentiality.
• Ensures compliance with VNS Health policies and procedures as well as all Federal and State regulations.
• Ensures that relevant team members receive important client/member alerts, including visits, hospitalization admission/discharge information, and other urgent notifications.
• Supports the clinical team with any changes that will impact members in maintaining the most independent living situation possible; including but not limited to client/member alerts, visits, hospital admission/discharge information, and other urgent notifications.
• Participates in special projects and performs other duties as assigned.

Benefits

• Referral bonus opportunities
• Generous paid time off (PTO), starting at 20 days of paid time off and 9 company holidays
• Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability
• Employer-matched retirement saving funds
• Personal and financial wellness programs
• Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care
• Generous tuition reimbursement for qualifying degrees
• Opportunities for professional growth and career advancement
• Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities
• Interdisciplinary network of colleagues through the VNS Health Social Services Community of Professionals.

What This Job Offers

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