Full-Time

Care Manager

Posted on 2/26/2025

Healthfirst

Healthfirst

1,001-5,000 employees

Compensation Overview

$71.6k - $116.5k/yr

Mid

Company Does Not Provide H1B Sponsorship

New Mexico, USA + 33 more

More locations: Washington, USA | Kansas, USA | Pennsylvania, USA | North Dakota, USA | Iowa, USA | Texas, USA | Montana, USA | Jackson Township, NJ, USA | Florida, USA | Waterbury, CT, USA | Nevada, USA | South Carolina, USA | Georgia, USA | Arizona, USA | Concord, NH, USA | Mississippi, USA | Tennessee, USA | Virginia, USA | Minnesota, USA | Colorado, USA | Utah, USA | Northeastern United States, USA | West Virginia, USA | New York, NY, USA | Maryland, USA | Maine, USA | Massachusetts, USA | North Carolina, USA | Oklahoma, USA | Louisiana, USA | Michigan, USA | Alabama, USA | United States

Category
Healthcare Administration & Support
Medical, Clinical & Veterinary
Requirements
  • Fluency in English and one of the following: Mandarin or Cantonese or Fujianese
  • NYS RN or LCSW or LMSW (any state)
Responsibilities
  • Advocates, informs, and educates beneficiaries on services, self-management techniques, and health benefits.
  • Conducts assessments to identify barriers and opportunities for intervention.
  • Develops care plans that align with the physician’s treatment plans and recommends interventions that align with proposed goals.
  • Generates referrals to providers, community-based resources, and appropriate services and other resources to assist in goal achievement and maintenance of successful health outcomes.
  • Liaise between service providers such as doctors, social workers, discharge planners, and community-based service providers to ensure care is coordinated and care needs are adequately addressed.
  • Coordinates and facilitates with the multi-disciplinary health care team as necessary to ensure care plan goals and treatment is person-centered and maximizes member health outcomes.
  • Assists in identifying opportunities for alternative care options based on member needs and assessments.
  • Evaluates service authorizations to ensure alignment and execution of the member’s care and physician treatment plan.
  • Contributes to corporate goals through ongoing execution of member care plans and member goal achievement.
  • Documents all encounters with providers, members, and vendors in the appropriate system in accordance with internal and established documentation procedures; follows up as needed; and updates care plans based on member needs, as appropriate.
  • Occasional overtime as necessary.
  • Additional duties as assigned.
Desired Qualifications
  • Strong interpersonal and assessment skills, especially the ability to relate well with seniors, their families, and community care providers, along with demonstrated ability to handle rapidly changing situations.
  • Fluency in Spanish, Korean, Mandarin, or Cantonese.
  • Knowledge and experience with the current community health practices for the frail adult population and cognitive impaired seniors.
  • Experience managing member information in a shared network environment using paperless database modules and archival systems.
  • Experience and knowledge of the relevant product line
  • Relevant work experience preferably as a Care Manager
  • Demonstrated ability to manage large caseloads and effectively work in a fast-paced environment
  • Proficient with simultaneously navigating the Internet and multi-tasking with multiple electronic documentation systems
  • Experience using Microsoft Excel with the ability to edit, search, sort/filter and other Microsoft and PHI systems

Company Size

1,001-5,000

Company Stage

N/A

Total Funding

N/A

Headquarters

New York City, New York

Founded

1993

Simplify Jobs

Simplify's Take

What believers are saying

  • Partnerships with tech firms like Hyphen boost innovative care solutions.
  • Healthfirst's health equity programs address disparities effectively.
  • Community health initiatives expand access to care in underserved regions.

What critics are saying

  • Competition from companies like Twilio offering integrated data solutions.
  • Pharmacy Incentive Program's reliance on community pharmacists poses operational challenges.
  • Dependence on partnerships for legal assistance may face disruptions.

What makes Healthfirst unique

  • Healthfirst collaborates with Hyphen to enhance value-based care through pharmacy programs.
  • The company focuses on health equity with initiatives like Healthfirst ADVANCE.
  • Healthfirst's community-based programs improve access to care in underserved areas.

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Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

401(k) Company Match

Performance Bonus

Company News

Business Wire
May 15th, 2024
Hyphen, Healthfirst Collaboration To Empower Pharmacists’ Role In Value-Based Care Receives 2024 Points Of Light Award From Klas Research

HARTFORD, Conn.--(BUSINESS WIRE)--Hyphen, the technology company creating connected-care, has received a 2024 Points of Light Award from KLAS Research, the leading healthcare research and insights firm, for its efforts to improve payer-provider collaboration in support of improved outcomes in value-based care with Healthfirst, a non-profit health plan serving close to 2 million New Yorkers. KLAS recognized Hyphen’s Pharmacy Assistant application, which supports Healthfirst’s Pharmacy Incentive Program. The program is designed to empower community pharmacists within Healthfirst’s network to take action to improve medication adherence rates, increase members’ understanding of their health plan benefits, and get compensated for those actions. This program is especially impactful because 80% of Medicare Advantage members in New York visit their community pharmacy 5-10 times annually — more than they visit their primary care doctor. The Pharmacy Assistant application connects disparate data sources and delivers real-time, actionable information in pharmacists’ existing workflows so they can close care gaps

MENAFN
Jan 25th, 2024
Montefiore Designated As A Behavioral Center Of Excellence, Granted $7M To Address Gaps In NYC Mental And Behavioral Health Care

New York State Office of Mental Health Funding to Support Plans for New Comprehensive Psychiatric Emergency Program and Outpatient Services Includin

WNewsJ
Sep 20th, 2023
Health First announces local grants

HealthFirst partnered with the Clinton County Foundation to ensure grant funding is annually available to the community.

Digit Kerala
Aug 10th, 2023
Health First Pharmacy Careers in Dubai - Abu Dhabi and Al Ain

Health First Pharmacy Careers UAE: Health First Pharmacy has published the latest job vacancies on its Careers page.

Clinton County Ohio Foundation
Aug 8th, 2023
Health First Renews Focus on Individual and Community Health and Wellness

HealthFirst partnered with the Clinton County Foundation to ensure grant funding is annually available to the community.

INACTIVE