Care Manager - Cluster Care
- Full-time
Company Description
Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow.
We’ve stayed true to our focus of finding qualified and experienced professionals in our specialty areas. Our partner-employers know that they can rely on us to find the right match between their needs and the abilities of our top-tier candidates. By continually exceeding their expectations, we have built successful ongoing partnerships that help us stay true to our commitments of performance and integrity.
Our team works hard to deliver a tailored approach for each and every client, critical in matching the right employers with the right candidates. We forge partnerships that are meant for the long term and align skills and cultures. At IRI, we know that our success is directly tied to our clients’ success.
Job Description
Responsible for the assessment, reassessment, care planning and coordination of care and services. Includes ongoing monitoring of an appropriate and effective person centered care plan, member education and care management. Regularly communicates with the members PCP and other providers, and integrates the member, caregiver and other provider feedback into the assessment and planning.
Qualifications
- Valid NYS RN License
- 2+ years’ experience in Behavioral Health
- Bachelor’s Degree
Additional Information
- 100% field work and 100% face-to-face member interaction.
- The candidate will oversee the care of member who will be transitioning to the community.
- He/ She will be assigned to 1-2 transitional homes.
- These homes are located in Westchester, Manhattan, Queens and the Bronx and Brooklyn. The member caseload of about 125. The manager is flexible with the start time, however, most Care Manager get started between 9am and 10am.
- Mileage is reimburse at $.535/mile. Mileage does not start from the candidate's home to the first location. Nor is mileage calculated from the last location to the candidate's home. Mileage begins from the first location to the next location.
- The candidate will have clinical experience with a focus in managed care, including disease or case management. Experience in utilization review, concurrent review and/or risk management a plus.
- Understands and is able to apply principals of Care Management and Person Centered Service Planning.
- Ability to apply Milliman Care Guidelines and other applicable, evidenced-based clinical guidelines. Ability to understand and apply coverage guidelines and benefit limitations. Familiar with clinical needs and disease processes for chronic physical and behavioral illnesses (depression, challenging behaviors, Alzheimer’s disease and other disease-related dementias).