H

Healthfirst

Non-profit insurer offering MLTC, Medicare Advantage.

Care Manager - Bilingual Fujianese

Clinical Support & Patient AdministrationConfirmed live in the last 24 hours
Full-timeRemote

About the Job

Requirements

  • For Medical Care Management, candidates must hold a New York State registered nurse license, or be a licensed clinical social worker or licensed master social worker from any state.
  • For pediatric Medical Care Management positions only, candidates must have one year of pediatric clinical field experience and/or experience with families and child-serving systems, including child welfare and/or medically fragile or developmentally disabled populations.
  • For Behavioral Health Care Management, candidates must hold a New York State registered nurse license, or be a licensed clinical social worker, licensed master social worker, licensed marriage and family therapist, licensed mental health counselor, licensed professional counselor, or licensed psychologist from any state.
  • For Behavioral Health Care Management, candidates must have three years of work experience in a mental or behavioral health or addictions setting.
  • For pediatric Behavioral Health positions only, candidates must have one year of pediatric clinical field experience and/or experience with families and child-serving systems, including child welfare and/or medically fragile or developmentally disabled populations.

Responsibilities

  • Advocate for, inform, and educate beneficiaries about services, self-management techniques, and health benefits.
  • Conduct assessments to identify barriers and opportunities for intervention.
  • Develop care plans that align with physicians’ treatment plans and recommend interventions that align with proposed goals.
  • Generate referrals to providers, community-based resources, appropriate services, and other resources to help members achieve their goals and maintain successful health outcomes.
  • Liaise between service providers, including doctors, social workers, discharge planners, and community-based service providers, to coordinate care and ensure member needs are addressed.
  • Coordinate and facilitate with the multidisciplinary health care team as necessary to ensure care plan goals and treatment are person-centered and maximize member health outcomes.
  • Assist in identifying alternative care options based on member needs and assessments.
  • Evaluate service authorizations to ensure alignment with and execution of the member’s care and physician treatment plan.
  • Contribute to corporate goals through ongoing execution of member care plans and member goal achievement.
  • Document encounters with providers, members, and vendors in the appropriate system according to internal and established documentation procedures; follow up as needed; and update care plans based on member needs, as appropriate.
  • Work occasional overtime as necessary.
  • Perform additional duties as assigned.

Desired Qualifications

  • Demonstrate strong interpersonal and assessment skills, particularly the ability to relate well with seniors, their families, and community care providers, and handle rapidly changing situations.
  • Be fluent in Fujianese.
  • Have knowledge and experience with current community health practices for the frail adult population and cognitively impaired seniors.
  • Have experience managing member information in a shared network environment using paperless database modules and archival systems.
  • Have experience and knowledge of the relevant product line.
  • Have relevant work experience, preferably as a Care Manager.
  • Demonstrate the ability to manage large caseloads and work effectively in a fast-paced environment.
  • Be proficient in simultaneously navigating the Internet and multitasking with multiple electronic documentation systems.
  • Have experience using Microsoft Excel, including editing, searching, sorting/filtering, and using other Microsoft and PHI systems.

About the Company

Healthfirst

Non-profit insurer offering MLTC, Medicare Advantage.

Healthfirst is a nonprofit health insurer in the New York metropolitan area offering a range of health plans, including Managed Long-Term Care (MLTC) for people who need ongoing care, Medicare Advantage with extra benefits, and the Essential Plan for income-qualified individuals. MLTC coordinates in-home and community-based care; Medicare Advantage combines Medicare with additional benefits in a single plan; the Essential Plan provides affordable coverage through a low-cost option, all delivered through a network of healthcare providers funded by premiums and government support. It differentiates itself through its nonprofit status, strong local focus, and partnerships that connect New Yorkers to a coordinated set of public-program-aligned products alongside Medicare Advantage. Its goal is to expand access to affordable, comprehensive health coverage for New Yorkers, especially vulnerable groups, by leveraging its local presence and provider network.

Company size
1,001-5,000
Company stage
Not listed
Total funding
Not listed
Headquarters
New York City, New York
Founded
1993

Recently Posted Jobs

Explore more opportunities at Healthfirst

See more jobs