Manager of Coordinated Care

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.

The employee is responsible for the oversight of the Care Management Department's daily operations and the Interdisciplinary Care Team and provides guidance and expertise as needed. Provides ongoing department training and updates to policies, regulations and workflows to ensure high quality and continuity of member care and appropriate allocation of member services and resources for both the Medicare and Medicaid populations.

• Bachelor's degree in nursing, public administration, gerontology, social work or related health care field required. Masters preferred.
• 3-5 years of management experience in a health care setting.
• Previous managed care experience preferred.
• Working knowledge of utilization management, case management and complex care philosophies.
• Previous Medicare and Medicaid experience. CCM preferred.
• Proficiency with Word/Excel, Internet access, telephone, fax.
• NYS RN license and registration or MSW/CSW CCM preferred.
• Excellent customer service, oral communication, writing, and typing skills.
• Ability to demonstrate effective critical thinking and problem solving skills.
• Excellent telephone assessment skills.
• Working knowledge of utilization management processes.
• Knowledge of Federal and State regulations, managed care regulations and concepts, and CQI methodologies.
• Ability to provide appropriate support and direction to facilitate collaborative efforts toward accomplishing Department goals and objectives.
• Ability to set priorities.