care manager

Rochester Regional Health

<div>Job Title: RN Care Manager 
Department: Greater Rochester Independent Practice Association (GRIPA) 
Location: 100 Kings Highway South, Rochester, NY 
Hours Per Week: 40 hours 
Schedule: Full-time, Days 
 
This position will be employed by the Greater Rochester Independent Practice Association, INC. (GRIPA). GRIPA was founded in 1996 as a unique collaboration between hospitals and physicians, for the purpose of simultaneously improving the quality and efficiency of health care. This position will not be employed by Rochester Regional Health (RRH). 
SUMMARY
As a Registered Nurse &ndash; Care Manager, your excellent interpersonal, leadership and collaboration skills ensure the appropriate allocation of hospital resources while maintaining the quality of care. Actively participates in the utilization management process using standards of care to determine the most appropriate level of care, participating in the development of plans for care, managing the care across the continuum to ensure a safe discharge in a timely manner.
RESPONSIBILITIES<ul><li>
Evaluation &amp; Review. Evaluate hospital admissions to assure care is medically necessary and delivered at the most appropriate level; actively participate in the concurrent review process and communicate/intervene with third party payors to ensure reimbursement for services are provided while maintaining quality of care
</li><li>Patient Management. Collaborate with providers, patients and families to address concerns and identify safe, effective discharge plans; intervene to identify and facilitate early referral for discharge planning; facilitate the discharge process by working with the healthcare team to identify alternative solutions to minimize system delays while ensuring a safe discharge plan</li><li>
Recommendation. Coordinate and participate in the development, implementation and revisions of evidence based clinical pathways and guidelines; participate in driving clinical and administrative compliance with care guidelines and core measures; identify and recommend actions for improvement</li></ul>
REQUIRED QUALIFICATIONS<ul><li>
Associate&rsquo;s Degree in Nursing (ASN)</li><li>
Registered Nurse with current New York State License</li><li>
AHA BLS</li></ul>
PREFERRED QUALIFICATIONS<ul><li>
Bachelors in Nursing (BSN)</li><li>
Three (3) years of acute hospital care, case management or utilization management experience</li><li>
Case Management Certification</li><li>
Excellent oral and written communication and interpersonal skills</li><li>
Good understanding of medical management techniques and processes</li><li>
Knowledge of federal and state regulations (DOH, Medicaid/Medicare)</li><li>
Strong organizational and problem-solving skills</li><li>
Knowledge of third party payor and/or managed care payment principles helpful</li></ul>
EDUCATION:
LICENSES / CERTIFICATIONS:
BLS - Basic Life Support - American Heart Association (AHA)American Heart Association (AHA), RN - Registered Nurse - New York State Education Department (NYSED)New York State Education Department (NYSED)
PHYSICAL REQUIREMENTS:
M - Medium Work - Exerting 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to move objects; Requires frequent walking, standing or squatting.
For disease specific care programs refer to the program specific requirements of the department for further specifications on experience and educational expectations, including continuing education requirements.
Any physical requirements reported by a prospective employee and/or employee&rsquo;s physician or delegate will be considered for accommodations.
PAY RANGE:
$80,750.00 - $110,290.00<div><div><div><div><div><div><div>
CITY:</div></div></div></div></div></div></div>
Rochester<div><div><div><div><div><div><div>
POSTAL CODE:</div></div></div></div></div></div></div>
14617
The listed base pay range is a good faith representation of current potential base pay for a successful full time applicant. It may be modified in the future and eligible for additional pay components. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.
Rochester Regional Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, predisposing genetic characteristics, marital or familial status, military or veteran status, citizenship or immigration status, or any other characteristic protected by federal, state, or local law.</div>

Care Manager-RN

Bayhealth

<div><div>If you care about the opportunity to grow, to make a difference, to build a future and a life, then we just might have the career for you. Care to talk?
 </div><div>Bayhealth Medical Center is Central and Southern Delaware&rsquo;s healthcare leader with hospitals in Dover and Milford, a s well as stand -alone Emergency Department in Smyrna and a hybrid E mergency Department and Urgent Care in Milton . We offer various practice settings throughout Kent and Sussex Counties. Bayhealth Medical Center Kent Campus is 90 minutes from Philadelphia, Washington, DC and Baltimore . Our Sussex Campus is 30 minutes to the Delaware beaches and relaxation in the sand!
</div><div>Bayhealth Medical Center offers a competitive salary and comprehensive benefits package (for eligible positions) including:
</div><div><ul><li>Generous Paid Time Off and Paid Holidays
</li><li>Matching 401(k)/403(b) Plans
</li><li>Excellent Health, Dental, and Vision
</li><li>Disability and Life Insurance options
</li><li>On Site Child Care
</li><li>Educational Reimbursement
</li><li>Health Care and Dependent Care Flex Spending Accounts
</li><li>Plus, an array of Voluntary Benefits to include Critical Care Coverage and more!
</li></ul></div>Location: Sussex Campus Hospital, Milford Delaware
Status: Full Time 80 Hours
Shift: Days
SALARY RANGE: 37.98 - 58.87HOURLY 
 
General Summary:
An RN who coordinates care and services of selected patient populations across the continuum of illness promoting effective utilization and monitoring of health care resources. Performs concurrent and retrospective patient reviews based on accepted quality, utilization, clinical risk and infection control criteria and communicates effectively with all members of the health care team regarding issues identified. 
 
Responsibilities:
1. Applies utilization management criteria for the review process, distinguishing levels of care and interacting with Physicians, other healthcare team member, and outside agencies.
 
2. Conducts patient screening for assessment of discharge planning interventions. Conducts simple discharges which include home health care, durable medical equipment, and authorizations pharmaceuticals. Provides communication to the Social Worker for complex discharge needs.
 
3. On a concurrent basis, assesses the appropriateness of the level of care; diagnostic testing and clinical procedures; performance and clinical risk issues; and documentation of medical record completeness and reports all variances and events.
 
4. Accurately and completely records all required clinical data in the data base to include information for reconsideration letters for denial of days and/or service.
 
5. Demonstrates ability to perform the Medicare denial process.
 
6. Recognizes urgent utilization issues and reports them to the Care Management manager, unit management, and attending physician immediately
 
7. All other duties as assigned within the scope and range of job responsibilities
 
8. ED Care Managers ONLY: Through an interdisciplinary team of health care providers, the care manager in collaboration with the physician will assist in coordinating a comprehensive plan of care using a concurrent integrated review process to determine medical necessity for appropriateness of admission. If admission is not appropriate then assist in a collaborative effort with the patient and significant other to enhance quality of care and focus on appropriateness of outpatient resource use.
 
9. Responsible, in coordination with the physician in developing and reviewing the individualized care plan, therefore assisting with the implementation of the plan of care. Communicate the plan of care with the entire health care team members. Facilitates the efficient delivery of care.
 
10. Assists the physicians with documentation compliance according to Medicare, Medicaid and Commercial payer regulations and guidelines.
 
11. Demonstrates ability to combine medical staff practice patterns, disease trajectory, community resource knowledge, and patient family desires into the critical thinking of discharge planning. Acts collaboratively with the emergency room navigator to coordinate discharge plans and arrangements for patient / families by ensuring a smooth transition from an emergency room level of care to another as required.
 
12. Conducts the initial assessment for the identification of potential discharge needs and provides communication to the Social Service Inpatient Discharge Planners.
 
13. Non-ED ONLY: Performs concurrent denial recovery of all denied days and records outcomes in the clinical data base. Requests sub-acute level of care when applicable to denied days.
 
14. Acts collaboratively with Social Services for post-hospital care needs 
 
 
Required Education, Credential(s) and Experience:
<ul><li>Education: Bachelor Degree
 
; Nursing
 
;
 
</li><li>Credential(s): Registered Nurse
 
Basic Life Support
 
; 
 
 
</li><li>Experience: Required: 5 years nursing experience within the last 10 years Preferred: Utilization Review, Care/Case Management experience
</li></ul>Preferred Education, Credential(s) and Experience:
<ul><li>Education:
</li><li>Credential(s): Certified Case Manager
 
Certified Professional in Utilization Review 
 
 
 
</li><li>Experience:
</li></ul>To view a full list of all open position at Bayhealth, please visit:
https://apply.bayhealth.org/join/</div>

RN Care Manager

StrongSteps Behavioral Health

Position SummaryStrongSteps Behavioral Health is seeking a compassionate and organized Care Manager to provide Enhanced Care Management (ECM) and Health-Related Social Needs (HRSN) services under New York&rsquo;s 1115 Waiver. The Care Manager will support Medicaid members experiencing behavioral health, housing, medical, or social instability by conducting screenings, eligibility assessments, care planning, and coordination with community providers.This position is ideal for a motivated professional who values community-based behavioral health work and trauma-informed care.Key Responsibilities<ul><li>Conduct Medicaid member screenings and eligibility assessments</li><li>Complete Enhanced Care Management Level 2 documentation</li><li>Develop and update individualized Social Care Plans</li><li>Coordinate services related to housing, transportation, utilities, food insecurity, and behavioral health</li><li>Provide follow-up care management contacts</li><li>Maintain accurate and timely documentation in compliance with SCN and Medicaid guidelines</li><li>Collaborate with DSS, housing providers, medical providers, and community partners</li><li>Participate in supervision and case review meetings</li><li>Maintain confidentiality and HIPAA compliance</li></ul>QualificationsRequired:<ul><li>Bachelor&rsquo;s degree in Social Work, Psychology, Human Services, or related field</li><li>Valid driver&rsquo;s license and reliable transportation</li><li>Strong documentation and organizational skills</li><li>Ability to work independently and in the community</li></ul>Preferred:<ul><li>Experience with Medicaid, Health Homes, or care management</li><li>Experience working with individuals experiencing housing instability or behavioral health challenges</li><li>Knowledge of New York 1115 Waiver or Social Care Networks</li><li>BSW, BA/BS in related field, or Certified Peer Specialist (NYCPS)</li></ul>Compensation<ul><li>$18&ndash;$24 per hour (based on experience)</li><li>Part-time or full-time opportunities available</li><li>Hybrid schedule (community visits + remote documentation)</li><li>Supervision provided</li></ul>Work EnvironmentThis role involves a mix of:<ul><li>Community-based visits</li><li>Phone coordination</li><li>Remote documentation</li><li>Occasional in-office or team meetings</li></ul>Why Join StrongSteps?StrongSteps Behavioral Health is a growing, mission-driven organization committed to expanding access to behavioral health and social care services across Upstate New York. We value compassion, accountability, and innovation in community care.Pay: From $18.50 per hourWork Location: Remote

Social Care Manager

NorthLakes Community Clinic

<div><h1 class="jobSectionHeader">Caring for our community starts with you. Join a team that believes everyone deserves care.</h1>
Candidates must reside within NorthLakes' service area at the time of hire and maintain residency throughout employment.
To engage teams and patients in the delivery of evidence-based, patient-centered, lifelong care. 
 
Salary begins at $29.95 + per hour depending on experience.
The RN Care Manager will manage high risk and chronic illness to promote whole-person, integrated, quality care. The RN Care Manager will employ a person-centered and team approach, partnering with patients and their family/caregiver(s), clinic/hospital/providers and specialty providers and other staff, and community resources.<ul><li>
Conduct in-office patient visits as outlined in care plan and based on patient&rsquo;s health status and self-management interests</li><li>
Create and promote engagement with a care plan, developed with the patient, primary care provider and/or specialty care provider and family/caregiver(s)</li><li>
Support the delivery of integrated, whole-person care in family medicine, recovery and psychiatric care.</li><li>
Engage patients in self-management and shared decision-making</li><li>
Increase utilization of preventative care services</li><li>
Promote timely access to appropriate care to reduce emergency room utilization and hospital readmissions</li><li>
Increase continuity of care by managing relationships with tertiary care providers, transitions-in-care, and referrals</li><li>
Work with internal providers on coordinating schedules, getting a client in to other service lines as needed</li><li>
Facilitate patient access to appropriate medical and specialty providers, assisting with residential and detox referrals</li><li>
Assist with the identification of &ldquo;high-risk&rdquo; patients with a chronic illness and those with special health care needs, coordinate care, and track outcomes</li><li>
Assess for social drivers of health and work with Community Health Workers on integrated Care Management</li><li>
Attend all Care Management training courses/webinars and meetings &ndash; contribute to the development of the Care Management Program</li><li>
Participate in quality improvement efforts by; utilizing dashboards, tracking tools and providing quality reporting data monthly</li><li>
Follow protocols, clinical policy and procedure in collaboration with the Primary Care Provider/Specialty Care provider for chronic care management. Follows clinical guidelines protocols and policies related to all direct patient care.</li><li>
Performs in-clinic triage and medication refills</li><li>
Work with Triage Nurse team as needed to perform medication refills and triage.</li><li>
Conducts nursing assessments according to assessment tools to determine services and service level of care needed.</li><li>
Under provider direction performs and/or assists provider in inductions utilizing COWS, administers patient injections and provides education on naloxone.</li><li>
Helps monitor OB clients, talking with their OB provider about pain management for delivery and postpartum.</li><li>
Provides education about Neonatal Abstinence syndrome, support systems, and concerns</li><li>
General Education with patients about substance use, tobacco cessation, prevention, communicable disease management, new medical diagnosis</li><li>
Monitor medication adherence, including checking the PDMP, help monitor side effects, provide patient education, assist prior authorizations and prescription assistance programs</li><li>
Provide medication reconciliation and complete refill requests, including for controlled substances under direction and approval from prescribing provider</li><li>
Connect patients to relevant community resources, with the goal of enhancing patient health and well-being, increasing patient satisfaction, and reducing health care cost
</li><li>Serve as the contact point, advocate, and informational resource for patients, care team, family/caregiver(s), payers, and community resources</li><li>
Facilitate and attend meetings between patient, family/caregiver(s), care team, and community resources, as needed</li></ul><div>
Qualifications and Education Requirements</div><div><ul><li>
Minimum Level of Completed Education: Associates Degree in Nursing</li><li>
Prior years of experience in similar role: RN with two+ years related experience and/or training</li><li>
Experience with systems, computer applications/software: Electronic Health Records, preferably Epic.</li><li>
Required (or Preferred) Licensure/Cert/Credentials: Current, valid and unrestricted WI license to practice as a Registered Nurse. Current CPR certification required.</li><li>
Evidence of leadership, communication, education and counseling skills. Local knowledge about community health care and social welfare resources preferred.</li></ul>
Benefit Statement
For full time and part time employees who work 24 or more hours per week we offer a generous benefits package that includes:<ul><li>Medical and dental insurance</li><li>Employer paid group term life and disability</li><li>Employer contribution toward Health Savings Account</li><li>Flexible Spending Accounts</li><li>Paid Time Off (PTO), Paid Holidays and Paid Leave Bank</li><li>403(b) with a 4% employer match</li></ul>
Various voluntary benefits:<ul><li>Vision Insurance</li><li>Supplemental Life, AD&amp;D and Disability</li><li>Tuition reimbursement</li><li>Health and Wellness reimbursement program</li><li>Employee Assistance Program, and other specialized behavioral health services and resources for employees and family members</li><li>Partner of HRSA/NHSC loan repayment program</li></ul>
Our Mission is to respond to the healthcare needs of our communities with an integrated array of quality services and actively remove barriers to wellness.
NorthLakes Community Clinic is an Equal Opportunity Employer. All qualified applicants will be considered for employment regardless of age, race, color, creed, religion, sex, sexual orientation, national origin, ancestry, marital status, disability, military or veteran status, or any other classification protected by applicable law.
All offers of employment are contingent upon successful completion of a criminal background check and references.</div>
At NorthLakes Community Clinic, our organizational competencies highlight the behaviors and values that guide how we work and provide a shared foundation for performance, development, and growth throughout an employee&rsquo;s career with us.
NorthLakes Community Clinic Organizational Competencies
Mission Driven - Advances the organizational mission, vision and values in executing job duties.
Customer Service - Committed to increasing customer satisfaction, sets proper customer expectations, assumes responsibility for solving customer problems, ensures commitments to customers are met.
Quality - Is attentive to detail and accuracy, is committed to excellence, looks for improvements continuously, monitors quality levels, finds root cause of quality problems, owns/acts on quality problems.
Creativity - Generates new ideas, supports change, provides innovative solutions, solves problems creatively.
Integrity - Earns the trust and confidence of coworkers and customers through honest communication, ethical behavior and professionalism in all interactions.
Teamwork - Contributes to meeting team deadlines and responsibilities, listens to others and values opinions, helps team to meet goals, welcomes newcomers and promotes a cooperative team atmosphere.
Self-Development - Seeks out and accepts feedback, is a proactive learner, takes on tough assignments to improve skills, keeps knowledge and skills up-to-date, turns mistakes into learning opportunities.
Job Knowledge - Understands duties and responsibilities, possesses necessary job knowledge and technical skills, maintains job knowledge current.
Communication - Understand and communicate effectively with others using a variety of contexts and formats, which include writing, speaking, reading, listening and interpersonal skills.
Dependability - Meets commitments, works independently, accepts accountability, handles change, sets personal standards, stays focused under pressure, meets attendance/punctuality requirements.
Trauma/Resilience Informed - Understands that trauma is prevalent and resilience can be cultivated and improved; and operates in a manner consistent with these principles.</div>

ELITE HOME HEALTH CARE

<div>The Client Care Manager is responsible for ensuring high-quality, client-centered homecare services by conducting client assessments, reassessments, hospital reassessments, verify clients&rsquo; individualized care plans, coordinating caregiver placements, monitoring service delivery, and acting as the primary liaison between clients, caregivers, families, and agency leadership. This role promotes exceptional client satisfaction, regulatory compliance, and smooth operational workflow. Compassionate, persistent and assertive Client Care Manager will have the overall responsibility of managing client and caregiver schedules to ensure consistent and thorough care is provided to our clients. You will be providing excellent customer service assistance when answering incoming calls from caregivers and clients during operational business hours, a couple nights a week and one weekend a month. As an integral member of our care team, you will play a crucial role in ensuring that effective and thorough communication is provided to our clients and caregivers with each interaction you encounter, promote client retention and abide by and enforce Delaware Caregivers policies and procedures. Assisting with scheduling conflicts, replacing previously scheduled caregivers when needed and thorough documentation is crucial to this role.
Responsibilities include but not limited to:<h3 class="jobSectionHeader">
Client Intake, Assessment &amp; Onboarding</h3><ul><li>
Conduct initial client assessments, home visits, and service evaluations to confirm or change client care needs.</li><li>
Ensure client individualized Care Plans reflect client goals, preferences, safety considerations, and required support.</li><li>
Confirm all intake and assessment documentation is complete, accurate, and compliant with agency and state requirements. 
 Ongoing Case Management</li><li>
Maintain regular contact with clients regarding care satisfaction, changes in condition, and service needs.</li><li>
Conduct routine in-home supervisory visits and reassessments per policy and regulatory timelines.</li><li>
Address client complaints or concerns promptly and professionally.</li><li>
Update care plans and service notes as needed based on client condition or feedback.</li><li>
Communicate service expectations clearly to clients and families.</li><li>
Manage and ensure your assigned clients have caregivers assigned to them for all shifts</li><li>
Communicate with caregivers via phone call, text and email</li><li>
Follow all after and on call policies and procedures</li><li>
Troubleshoot caregiver clock in and out issues</li><li>
Update clients on scheduling or time concerns</li><li>
Check caregiver notes daily</li><li>
Respond to caregiver shift concerns</li><li>
Document client and caregiver concerns</li><li>
Other duties as assigned</li><li>
Collaborate with on-call Scheduler when needed</li><li>
Perform meet &amp; greet visits with new clients and caregivers</li><li>
Track client service hours, schedule changes, and caregiver assignments in collaboration with other Client Case Managers</li></ul>
Quality Assurance &amp; Compliance<ul><li>
Ensure all client files are complete, compliant, and updated (care plans, supervisory notes, assessments, incident reports, etc.).</li><li>
Maintain up-to-date knowledge of state regulations and agency policies.</li><li>
Participate in internal audits, quality improvement initiatives, and training programs.</li><li>
Report incidents, changes in condition, and safety hazards immediately and ensure follow-up. 
Communication &amp; Collaboration</li><li>
Serve as the primary point of contact for clients, families, caregivers, and case managers.</li><li>
Provide timely updates to agency leadership regarding client status, risks, or service challenges.</li><li>
Attend interdisciplinary meetings, staff meetings, and case reviews.</li><li>
Document all communication and follow-up in the client record system (e.g., AxisCare).</li></ul>
Bachelor degree in Healthcare Administration or Social Work a plus, Bachelor or Associate degree in Social Work, Human Services, Nursing, or related field preferred.<ul><li>
Two or more years of experience in homecare, case management, or human services required.</li><li>
Knowledge of state homecare regulations, client rights, and service standards.</li><li>
Strong interpersonal, communication, and problem-solving skills.</li><li>
Proficiency in homecare scheduling or client management software (e.g., AxisCare, ClearCare, HHAeXchange).</li><li>
Valid driver&rsquo;s license and reliable transportation for home visits.</li><li>
Additional training or certifications in homecare or caregiving is a plus</li><li>
Empathetic and patient nature, with a genuine passion for helping others</li><li>
Strong communication skills to interact effectively with clients, family members, and healthcare professionals</li><li>
Ability to adapt to various situations, prioritize tasks, and respond calmly in emergency situations</li><li>
Basic computer skills for record-keeping purposes; experience with scheduling applications is a plus</li><li>
Must have up-to-date physical, TB test, background check and drug test or willing to undergo each</li><li>
Strong and effective communication skills</li><li>
Excellent customer service skills</li><li>
Must be a team player and able to work independently</li><li>
Great organization skills, attention to detail and problem solving ability</li><li>
Proven experience in providing direct care to individuals, preferably in a home or community setting</li></ul>
Reports To: Director of Operations, CEO
This is a salaried position
HOURS: 8am-5pm Monday; 9am - 5pm Tuesday-Thursday; 9am - 4pm on Friday. On-call 2 nights a week &amp; 1 weekend a month (on-call may include covering shifts on the weekends or in the event you do not get shifts covered during the week); Four (4) mandatory Quarterly 2-hour remote in-services a year.</div>

Client Care Manager

Serene health

<div><div>Empowering Wellness, Transforming Lives

Optima Medical Management Group is dedicated to enhancing the quality of life by promoting wellness. At Optima MMG and all of its divisions: Serene Health, Community Support, and American TrueCare, our mission is to provide comprehensive support and care that not only addresses immediate concerns but also fosters long-term well-being.

As pioneers in the field, we aspire to lead in member care outcomes and set new standards for excellence and innovation. We are committed to empowering our members to achieve self-sufficiency in health, creating a ripple effect that strengthens families and communities.

Our work culture at Optima MMG is built on pride, passion, and a collective commitment to making a positive difference in people's lives. Our team members are dedicated problem-solvers who bring their unique skills and perspectives to the table. We believe that by fostering a collaborative and supportive environment, we can unlock the full potential of our team and, in turn, provide the best possible care to our members.

A career at Optima MMG is an opportunity to be part of a dynamic and forward-thinking organization. We encourage continuous learning and professional growth, providing our employees with access to industry experts, cutting-edge technologies, and a supportive community that values each individual's contributions. Join us on this journey to not only advance your career but to be a driving force in transforming lives and communities through passionate and fulfilling work!</div>

Job Summary:

The official job title is Lead Care Manager (LCM).

The Lead Care Manager (LCM) role involves developing personalized care plans, coordinating member services, and collaborating closely with members and families, as well as Primary Care Providers to ensure they receive necessary medical treatment and support. The LCM will consult with members to determine their needs, develop individualized action plans, and work with care teams to manage the member experience effectively. Providing emotional support, resolving administrative issues, and ensuring timely access to care are key aspects of the position. Compassion, healthcare knowledge, and exceptional customer service are essential qualities for assisting members in becoming self-sufficient in health. The LCM will work with a diverse population of members enrolled in the Enhanced Care Management program, which may involve one or multiple members from the population of focus section below.

Responsibilities:
<ul>
<li>Interview members to assess medical and social determinant of healthcare gaps and provide education about their condition and medication, while developing individualized care plans.</li>
</ul><ul><li>Respond to member inquiries and concerns, ensuring adherence to hospital and legal requirements.</li>
</ul><ul><li>Collaborate with interdisciplinary teams, locate medical and social resources, and coordinate social service plans.</li>
</ul><ul><li>Maintain on-going contact with members, via telehealth and in-person visitation.</li>
</ul><ul><li>Advocate for members, consult with healthcare providers, arrange appointments and treatment plans, evaluate member progress, and assist with healthcare barriers.</li>
</ul><ul><li>Maintain empathy and professionalism while contacting members and families.</li>
</ul><ul><li>Supporting behavioral health coordination, Substance Abuse and Community Resources.</li>
</ul><ul><li>Perform additional duties as assigned.</li></ul> 


Populations of Focus:
<ul>
<li>Individuals experiencing homelessness: Lacking a fixed, regular, and adequate nighttime residence.</li>
</ul><ul><li>Individuals at risk for avoidable hospital or emergency department utilization: Five or more emergency room visits in a six-month period that could have been avoided with appropriate outpatient care or improved treatment adherence.</li>
</ul><ul><li>Individuals with Serious Mental Health and/ or substance use disorder needs: Adults who meet the eligibility criteria for participation in, or obtaining services through Specialist mental health services or the Drug Medi-Cal organized delivery system or Drug Medi-Cal program.</li>
</ul><ul><li>Individuals transitioning from incarceration/Justice Involved: Adults transitioning from a correctional setting or transitioned from a correction setting within the past 12 months, or children and youth who are transitioning from a youth correctional facility or transitioned from being in a youth correctional facility within the past 12 months.</li>
</ul><ul><li>Adults living in the community and at risk for long-term care institutionalization: Adults who are living in the community who meet the SNF Level of Care criteria; or who require lower-acuity skilled nursing or equipment for prevention, diagnosis, or treatment of acute illness or injury.</li>
</ul><ul><li>Adult nursing facility residents transitioning to the community: Adult nursing residents who are interested in moving out of the institution, and are likely candidates to do so successfully, and are able to reside continuously in the community.</li>
</ul><ul><li>Children and youth enrolled in California Children's Services (CCS) or CCS Whole Child Model (WCM) with Additional Needs Beyond the CCS condition: Children and youth enrolled in CCS or CCS WCM and are experiencing at least one complex social factor influencing their health.</li>
</ul><ul><li>Children and Youth Involved in Child Welfare</li>
</ul><ul><li>Individuals with Intellectual/ Developmental Disabilities: Adults who have a diagnosed I/ DD and qualify for eligibility in any other adult ECM population of focus.</li>
</ul><ul><li>Pregnant and Postpartum individuals; Birth Equity Population of Focus: Adults and youth who are pregnant or postpartum and qualify for eligibility in any other adult or youth ECM POF, or are subject to racial and ethnic disparities.</li>
</ul>
Education and Experience:
<ul>
<li>High school diploma or GED required.</li>
</ul><ul><li>Minimum of 1 year experience in case management, member care, customer 
service, call center, or member care required.</li>
</ul><ul><li>Valid California driver's license and valid vehicle insurance required.</li>
</ul><ul><li>MA certificate or medical terminology knowledge preferred.</li>
</ul>
Required Skills/Abilities:
<ul>
<li>Excellent communication, interpersonal, customer service and organizational skills.</li>
</ul><ul><li>Computer skills for documentation, email and chat support.</li>
</ul><ul><li>Proficient skills in working independently and collaboratively in a team to provide member care.</li>
</ul><ul><li>Proficiency in multitasking, organization, and attention to detail is required for effectively providing care to multiple members simultaneously.</li>
</ul><ul><li>Candidates should exhibit the capability to utilize resources effectively for problem-solving while maintaining composure under pressure in a compassionate manner.</li>
</ul><ul><li>Applicants must demonstrate proficient speaking, reading, and typing abilities and possess strong proofreading skills.</li>
</ul>
Physical Requirements:
<ul>
<li>Must be able to travel using personal vehicle to complete outreach visits. Mileage reimbursement for the use of your vehicle is at a standard rate.</li>
</ul><ul><li>Must successfully complete and maintain current Tuberculosis (TB) testing and clearance in accordance with company policy and applicable local/state health regulations as a condition of employment.</li>
<li>Prolonged periods of sitting at an office desk on the computer.</li>
<li>Lifting: Able to lift up to 15lbs.</li>
</ul><div>
Benefits

Our full-time employees are eligible for the following benefits enrollment after 60 days of employment:

Medical, Dental, &amp; Vision Benefits: We have various insurance options for you and your family.

Short &amp; Long-Term Disability Benefits: Protection when you need it most.

Voluntary Accident, Voluntary Critical Illness, and Voluntary Hospital Indemnity Plans: Added security for you and your loved ones.

Flexible Spending Accounts: Manage your finances with flexibility.

Employee Assistance Program (EAP): Support when life throws challenges your way.

401(K): Building your financial future with us. Effective after 1 year of employment.

Paid Vacation and Sick Leave: Flexibility for the planned and unplanned.

Paid Holidays: Quality time to enjoy celebrations.

Employee Referral Program: Share the opportunities and reap the rewards.

Company Discount Program: Enjoy savings on everyday expenses and memberships. 


Equal Employment Opportunity

Optima Medical Management Group and its divisions are an Equal Opportunity Employer. Optima MMG is committed to providing employment opportunities for all qualified candidates without discrimination on the basis of race, religion, sex, sexual orientation, gender identity, age, national origin, citizenship, disability, marital status, veteran status, or any other characteristic protected by federal, state or local laws. Optima MMG is committed to providing reasonable accommodation for individuals with disabilities.

Pre-Employment

Optima Medical Management Group is a drug-free workplace. Employment is contingent upon a successful pre-employment drug screening and background check.</div></div>

Lead Care Manager

Guardian Angel Senior Services

<div><div><div>Guardian Angel Senior Services is looking for a full-time Associate Home Care Manager in our Gloucester Office! 
</div><div>
JOB SUMMARY: 
 
To oversee day-to-day functions of the office in accordance with current federal, state and local standards, guidelines and regulations that govern home care. Mange home care services for Nursing, Home Health Aide/CNA, PCA, Homemaker, and Companion while keeping outstanding quality client care and customer satisfaction. Ensure organizational effectiveness by providing leadership and setting the standard for performance. Maintain and create new contacts to drive business on a consistent basis. Contribute to the development and implementation of organizational strategies, policies, and practices. This position will oversee and back up scheduling, work closely and collaboratively with recruitment and support positions in need of help.</div><div></div><div>
QUALIFICATIONS &amp; EXPERIENCE:</div><ul><li>
A minimum of two (2) years&rsquo; experience and personal care experience is required.</li><li>
A minimum of two (2) years&rsquo; management experience is required, preferably that of paraprofessionals, with proven ability to build and lead teams.</li><li>
Ability to interface effectively and professionally with clients and families.</li><li>
Knowledge of government contract management with ASAPS a plus</li><li>
Proficiency in Microsoft Office as well as a comfort level in using the Internet and email and documenting electronically.</li></ul><ul><li>
Ability to handle stressful situations with compassion, understanding and patience.</li><li>
Can operate with a sense of urgency and is resourceful and proactive.</li><li>
Possess excellent decision making, negotiation, and time management skills.</li><li>
Ability to work through frequent interruptions.</li><li>
Ability to work beyond normal working hours including evenings, nights, weekends, and/or holidays and in other positions temporarily, when necessary</li><li>
Has a valid MA driver&rsquo;s license, a vehicle available for work-related travel, and appropriate insurance is required?</li></ul><div>
Able to participate in off hours On-Call back up support and coverage. 
 
PRIMARY RESPONSIBILITIES:</div><div><div><div><div> 

Operations</div><ul><li>
Set the standard for the acceptance of new clients and hitting goals for hours of service.</li><li>
Identify opportunities for network development with each new lead and work with Regional Manager to follow-up.</li><li>
Oversee all aspects of scheduling including but not limited to making proper client &amp; caregiver matches, urgently addressing available shifts, reviewing accuracy of data entry, reducing cancellations, overtime, and scheduling On-Call.</li><li>
Develop schedules collaboratively with clients and caregivers using creativity and problem-solving skills.</li><li>
Determine when caregiver schedules need to be swapped based on client priority levels.</li><li>
Develop keen insight into the needs of clients and strengths of caregivers to match appropriately.</li><li>
Guarantee necessary communication with clients, families, caregivers, case managers and other involved parties through ongoing home visits, meetings, telephone contact, email updates and written documentation.</li></ul></div></div><div> 
<ul><li>
Ensure client plans of care are up to date in collaboration with Managers and Nursing staff.</li></ul></div><div> 
<ul><li>
Responsible for the delivery of competent, quality patient care in the home.</li><li>
Anticipate client / caregiver issues to maintain quality care within client home and investigate potential risk management issues.</li><li>
Assist in the recruiting of office staff.</li><li>
Manage phone triage and interoffice communication.</li><li>
Prepare schedules for payroll.</li><li>
Train new office and On Call staff and improve retention by ensuring new staff including caregivers are properly welcomed to the organization and are communicated with consistently during their first months of employment.</li><li>
Oversee management of Caregiver holiday schedules</li><li>
Run monthly reports for follow-up including Caregiver Reminders, Caregiver Annual evaluations, ASAP Personal Care Annual Updates, Cancelled Shifts, Overtime and Waiver monthly reports.</li><li>
Participate in quarterly QA meetings.</li><li>
Perform Home Visits as needed, creating care plans, completing paperwork</li></ul></div><div><div><div> 
Supervisory</div><ul><li>
Provide inspiration, leadership, and motivation to staff.</li><li>
Provide vision and builds buy-in among staff for addressing current priorities and identifying new opportunities.</li><li>
Hold regular meetings with office staff upholding accountability for key performance indicators and supporting in achieving goals.</li><li>
Identify caregivers in need of continued support, education and training and work with nursing to implement training.</li><li>
Shepard new caregivers into the schedule appropriately matching them with clients within their skill levels.</li><li>
Provide disciplinary action and documentation for all Caregivers and Scheduling Coordinators.</li><li>
Participate in the development and implementation of staff in-services programs.</li><li>
Audit client and caregiver files for contract compliance and serve as a liaison for Contract/Case Managers.</li><li>
Ensure compliance with:<ul><li>
Caregiver quarterly and annual evaluations.</li><li>
State funded visit, supervision, and placement requirements.</li><li>
Caregiver employment paperwork</li></ul></li><li>
Mange Office schedules (alerts, time off, cleaning, On Call, storm coverage, overtime, office dispatch)</li><li>
Oversee On Call Reports, follow up and outside On Call Managers</li><li>
Ensure Call Centers are closed out each month.</li><li>
Oversee shared email inboxes.</li><li>
Work with office team to resolve problems and issues that happens regarding Client, Client Families, and Caregivers, including writing incident, DPH and Worker&rsquo;s Compensation reports.</li></ul><div>
EDUCATION:</div><ul><li>
Bachelor&rsquo;s degree in a Health or Human Service-related field preferred.</li></ul></div></div> 
</div><div> 

WORKING CONDITIONS: 
 
Work is performed approximately 80% in an office and 20% in client homes and in the community. Potential hazards include working with emotionally unstable, noncompliant, or aggressive clients and complex family dynamics, driving in inclement weather, second-hand tobacco smoke, aggressive animals, exposure to contagious diseases. 
 
The Associate Home Care Manager must have the ability to meet the following physical requirements: 
</div><ul><li>
Must be able to move intermittently throughout the workday.</li><li>
Must demonstrate sufficient strength, endurance and flexibility to perform job duties.</li><li>
May require extended periods of sitting or standing.</li><li>
Must meet the general health requirements set forth by the policies of the agency which may include a physical examination and annual TB test.</li><li>
Must be able to push, pull, move, and/or lift a minimum of twenty (20) pounds to a minimum height of three (3) feet and be able to push, pull, move, and/or carry such weight a minimum distance of five (5) feet.</li></ul><div>
Submit your resume now for consideration 
or 
Call the Gloucester office @ (978) 296-7200! 
email tyoung@gaseniorservices.com</div><div>
</div><div>
Guardian Angel Senior Services is an Equal Opportunity Employer. We do not discriminate against race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, age, disability, or genetic information.</div></div>
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Associate Home Care Manager

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