The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.
Provides telephonic assessments of members’ medical, psychosocial, physical, and spiritual needs. Utilizes completed UAS-NY assessments to develop a Person-Centered Service Plan (PCSP).
Responds to changes in members’ condition/sentinel events (i.e. level of care changes, changes in family support, changes in housing, etc.) by revising the PCSP and communicating changes with interdisciplinary care team and PCP.
Responds to requests for service within Medicare/Medicaid regulated time frames utilizing appropriate correspondence as per DOH/CMS regulations and departmental workflows.
Participates in and presents cases at the Interdisciplinary Care Team meetings to discuss any changes in member’s condition/sentinel events (i.e. level of care changes, changes in family support, changes in housing, etc.) identified during assessment process.
Collaborates with interdisciplinary care team members, such as Primary Care Physician, Social Worker, Specialists, Hospice/Palliative team, and Chief Medical Director when complex social/medical focus areas are identified during the assessment/care planning process as per unit workflows.
Educates members on Advanced Directives/Health Care Proxy/Power Of Attorney (POA) and helps to facilitate the completion of such documentation.
Associate’s Degree in Nursing for experienced candidatesBSN for new graduatesNYS RN license requiredCCM preferred1 year of RN experience in managed care, home care, acute care or nursing home preferred Read LessThe challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.
Provides telephonic assessments of members’ medical, psychosocial, physical, and spiritual needs. Utilizes completed UAS-NY assessments to develop a Person-Centered Service Plan (PCSP).
Responds to changes in members’ condition/sentinel events (i.e. level of care changes, changes in family support, changes in housing, etc.) by revising the PCSP and communicating changes with interdisciplinary care team and PCP.
Responds to requests for service within Medicare/Medicaid regulated time frames utilizing appropriate correspondence as per DOH/CMS regulations and departmental workflows.
Participates in and presents cases at the Interdisciplinary Care Team meetings to discuss any changes in member’s condition/sentinel events (i.e. level of care changes, changes in family support, changes in housing, etc.) identified during assessment process.
Collaborates with interdisciplinary care team members, such as Primary Care Physician, Social Worker, Specialists, Hospice/Palliative team, and Chief Medical Director when complex social/medical focus areas are identified during the assessment/care planning process as per unit workflows.
Educates members on Advanced Directives/Health Care Proxy/Power Of Attorney (POA) and helps to facilitate the completion of such documentation.
Associate’s Degree in Nursing for experienced candidatesBSN for new graduatesNYS RN license requiredCCM preferred1 year of RN experience in managed care, home care, acute care or nursing home preferred Read LessThe challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.
Conduct in-person care management visits to identify and provide appropriate interventions based on the psychosocial, environmental, and spiritual needs of the member. Use pre-established criteria & care management scripts to identify Social Determinants of Health (SDOH) needs while in the members’ home, in accordance with departmental workflow.
Provide education on how to access covered and non-covered benefits and ensure continuity of care across all healthcare settings by collaborating with the interdisciplinary team. Utilize benefit structure and community-based resources to address member needs. Educate members on preventative health, quality of life interventions, plan benefits, Advanced Directives/Health Care Proxy/Power of Attorney (POA) and help to facilitate the completion of such documentation.
Bachelor's psychology or related health field preferred.Minimum 1-2 years of relevant work experience in long term care, managed care, home care, geriatrics, hospital setting, or hospice.Prior experience in an interdisciplinary service delivery environment preferred.Working knowledge of Medicare and Medicaid regulations.Strong background in addressing Social Determinants of Health/Certification. Read LessThe challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.
Community Health Coach will conduct in-person care management visits to identify and provide appropriate interventions based on the psychosocial, environmental, and spiritual needs of the member. The employee will provide education on how to access covered and non-covered benefits and ensure continuity of care across all healthcare settings by collaborating with the interdisciplinary team; Primary RN/SW Care Manager and member/member’s representatives. Utilize benefit structure and community-based resources to address member needs. Educate members on preventative health, and quality of life interventions. Community Health Coach will be knowledgeable in and adhere to CMS/DOH regulations and policies. The Community Health Coach is responsible for the completion of in-person care management visits to Elderplan/HomeFirst members semi-annually as per pre-established criteria & care management scripts to identify Social Determinants of Health (SDOH) needs while in the members’ home, in accordance with departmental workflow. They educate members on plan benefits, preventative health, Advanced Directives/Health Care Proxy/Power of Attorney (POA) and help to facilitate the completion of such documentation. The Community Health Coach will collaborate with the Primary Care Management, report findings, & submit completed documentation to the Support Staff Supervisor.
Bachelor’s degree in Social Work, psychology or related health field required.Minimum 1-2 years of relevant work experience in long term care, managed care, home care, geriatrics, hospital setting, or hospice.Prior experience in an interdisciplinary service delivery environment preferred.Working knowledge of Medicare and Medicaid regulations.Strong background in addressing Social Determinants of Health/Certification. Read LessThe challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.
Reporting to the Supervisor of Care Management this position will provide case management to our members including medical, social, psychological, physical, and spiritual needs by developing, implementing, and monitoring the care plan in conjunction with the PCP, caregivers, and other team members to help meet the member's needs.
Associate’s Degree in Nursing for experienced candidatesBSN for new graduatesNYS RN license requiredCCM preferred1 year of RN experience in managed care, home care, acute care or nursing home preferred Read LessThe challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.
$15,000 Sign-On Bonus or Student Loan Assistance!
Reporting to the Supervisor of Care Management this position will provide case management to our members including medical, social, psychological, physical and spiritual needs by Developing, implementing and monitoring the care plan, in conjunction with the PCP, caregivers and other team members, to help meet the member's needs.
Associate’s Degree in Nursing for experienced candidatesBSN for new graduatesBilingual Bengali, Cantonese, Mandarin and/or Spanish required NYS RN license requiredCCM preferred1 year of RN experience in managed care, home care, acute care or nursing home preferred Read Less