Care Manager
LIFEPlan CCO NY LLC·Clifton Park, New York
LIFEPlan CCO NY LLC·Clifton Park, New York
The Care Manager oversees and coordinates access to services for individuals with intellectual and developmental disabilities by developing and monitoring person-centered Life Plans. They also advocate for members to ensure they receive necessary medical, behavioral, and community support services.
Deliver person-centered care management services in compliance with regulatory standards and in alignment with the agency’s quality management plan, policies, and standard operating procedures. Responsible for the completion of a comprehensive assessment/reassessment process. Identify gaps in service provision and make referrals when appropriate. Advocate on the member’s behalf, to reach their identified goals and live a meaningful and quality life. Develop, implement and monitor member Life Plans within required timeframes, by leading an interdisciplinary team planning process, with the person at the center. Develop strategies that address conflict or disagreements in the person-centered planning process and work with the interdisciplinary team to resolve those conflicts in a timely manner. Complete all required service documentation with stated timeframes. Ensure all billing critical documentation is present and valid prior to the submission of any billable service documentation. Maintain the member’s continued eligibility for care management through the completion of an annual Level of Care (Re)Determination, ensuring OPWDD eligibility is maintained, and enrolling in the Home and Community Based (HCBS) waiver. Identify and access benefits and entitlements (Medicaid, Social Security, SNAP, etc.) when a member is eligible. Ensure existing benefits and other entitlements are maintained. Ensure a current and accurate information sharing consent is present within the electronic health record and updated as necessary when changes occur or are requested by the member and/or representative. Coordinate and provide access to high quality healthcare services, inclusive of medical, behavioral health, and specialized services. Provides regular communication, monitoring, and action-oriented follow-up on critical and acute healthcare needs. Identify, coordinate, and provide access to preventative and health promotion services as needed. Coordinate transitional care inclusive of appropriate follow-up from inpatient to other settings, discharge planning, facilitating transfers within the healthcare system, residential settings and aging out of childhood services to adult services. Foster self-determination and community inclusion through linkage and referral to community-based resources related to the members' interests, goals and abilities. Use health information technology in the delivery of care management services, included but not limited to the use of electronic health records and programs to facilitate telehealth services for members. Maintain a thorough and accurate electronic health record for all assigned members. Support members self-advocacy utilizing a person centered and strength-based approach and as necessary provide advocacy with and on behalf of members to ensure service needs are met to the fullest extent. Attend department/team meetings, trainings, supervisions, etc. as scheduled and in accordance with agency practice and policy. Complete all required trainings within required timeframes. Travel throughout the designated service area to meet with members as needed in alignment with regulatory standards and to ensure identified needs are met. Travel is required to meet with providers, members of the interdisciplinary team, and accompany members where indicated to necessary appointments. Identify and follow all incident reporting guidelines and procedures, ensuring the immediate safety of the member. Adhere to all policies and standard operating procedures for the delivery of comprehensive care management and ancillary functions of the Care Manager. Actively complies with all standards of conduct as determined by – e.g., internal Corporate Compliance Regulations, OPWDD, DOH and the Justice Center. Maintain confidentiality in accordance with HIPAA and privacy practices. Perform other duties as assigned. Must possess a valid Driver’s License from New York, or a contiguous state (i.e., Connecticut, New Jersey, Pennsylvania, and Vermont) and dependable vehicle required for frequent travel. QualificationsEducation and Experience: A Bachelor of Arts or Science degree with two years of relevant experience, or a license as a Registered Nurse with two years of relevant experience, or a master’s degree with one year of relevant experience. Degrees in the field of Health and Human Services, Psychology, Sociology, or related fields are preferred. Work with people with intellectual and/or developmental disabilities, case management, or in the Mental Health or Substance Abuse field, or related experience preferred. Must be able to meet members in their homes or other community locations of their choosing. Travel to off-site locations required. The incumbent must be comfortable driving. Must reside in New York State, or a contiguous state (i.e., Connecticut, New Jersey, Pennsylvania, and Vermont) and the residence must be within 100 miles to the assigned office Hub. Must possess proof a valid Driver’s License from New York, or a contiguous state and dependable vehicle required for frequent travel between sites. Proof of valid auto insurance for standard personal vehicles will be required at the time of hire. Excellent interpersonal, public speaking, and written communication skills. Ability to work autonomously. Demonstrate professionalism, respect, and ability to work in a team environment. Absolute sense of integrity and personal commitment to serving people with I/DD and their families. Physical Requirements: Prolonged periods of sitting at a desk and working on a computer. Ability to climb stairs- Please note that not all member meetings will be held in locations that are ADA compliant. Ability to travel in a vehicle for more than 1 hour. Work Environment:This is not a remote position. This is a flexible work environment position with a blend of work from home, field work, and regional travel as well as in office expectations. Whether working from an approved office site, one’s home, or another remote location, each employee is required to follow minimum privacy standards when working in the flexible work environment: Employee has access to a password secured WiFi connection and/or ACA/NY Mobile Hotspot. Employee is able to secure any printed materials containing individual or employee personal and/or health information, so as no one else in the household will be able to access it. Employee is able to conduct phone and video calls in a private area where the conversation cannot be overheard, and their screen is not visible to others. Employee is able to conduct their work in a location where personal and health information on a monitor is not visible to others. Most of the working hours will be Monday-Friday; expected to be flexible with work hours. Certain deadlines and unexpected developments may require work hours during evening and weekends, as well as hours that exceed the standard number of hours. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets, etc. The noise level in the work environment is usually moderate. Travel to off-site locations is required; therefore, the incumbent must be comfortable driving. AAP/EEOC LIFEPlan provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, or genetics. In addition to federal law requirements, the organization complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, training, and all other legally protected classifications.
Candidates must possess a Bachelor's degree with two years of relevant experience, or a Registered Nurse license with two years of experience, or a Master's degree with one year of experience. A valid driver's license and a dependable vehicle are required for frequent travel to meet with members and providers.
Market context
Care Manager roles in New York are often competitive because employers look for a mix of education, care coordination experience, and strong communication skills. This posting calls for a bachelor’s degree with 2 years of experience or a master’s degree with 1 year, plus Microsoft Office proficiency; Spanish bilingualism is preferred. Review the AI-summarized requirements and benefits here to save time, then tailor your application to show organized case management and patient-facing communication experience.
Care Manager
Care Manager
Care Manager