Case Manager, MVP Health Care

Posted: 05/02/18 | SHARE:

Description:

MVP Health Care is a nationally-recognized, regional not-for-profit health plan.  We are committed to having a positive impact on the health and wellness of everyone and every community we serve. We care for more than 700,000 members across New York and Vermont, and we are powered by the ideas and energy of more than 1,600 employees – providing a wide range of health benefit plan options with attentive service and flexibility normally associated with a smaller company.  Stop settling for “just a job,” and join a company where you can reach your full potential…and make a positive difference!

The Case Manager will utilize the essentials of an integrated case management model that includes assessment, planning, implementation, care coordination, monitoring and advocacy to meet the member’s overall comprehensive health needs. Through collaborative efforts the Case Manager will identify the medical and psycho-social needs of designated members, act as a proactive partner, and provide appropriate education, resources and healthcare coaching telephonically or “face to face”. The principle role of the position is to engage individual members, and communicate with an established interdisciplinary team to create an individualized person centered care plan. In addition, the position will provide guidance in understanding benefit coverage and navigating the health care delivery system. The overall objective is to create solutions to overcome barriers to care and assist the member achieve optimum health and/or improved functional capability through the coordination of quality cost effective care. The Case Manager will also monitor and review cases with the Medical Director to ensure appropriate outcomes. Other duties as assigned by supervisor.

 

Qualifications:

Minimum Education:

  • Current New York State Licensure as a Registered Nurse or Social Worker.
  • Bachelor's degree in nursing preferred
  • Case Management Certification a Plus (ANCC or CCM)

Minimum Experience:

  • Minimum of years of recent clinical and Case Management experience.  
  • Certification in Case Management required within 24 months after hire. 

 Required Skills:

  • Ability to .professionally communicates with members, and all interdisciplinary team members.
  • Excellent oral and written communication skills
  • Demonstrated clinical knowledge including an understanding of population health management and the case management process.
  • Detail oriented with strong organizational skills including the ability to manage time wisely to meet established deadlines.
  • Ability to work in an energetic team environment.
  • Experience with situations requiring strict adherence to confidentiality.
  • Ability to solve problems while exhibiting clinical judgment and realistic understanding of the current environment.
  • Ability to make independent decisions regarding resource utilization, and quality of care.
  • Must demonstrate understanding of clinical and psychosocial issues that may alter treatment or care plan and be able to demonstrate good judgment when dealing with emotionally charged situations
  • Strong computer skills including working knowledge of Word, Windows based applications, typing and internet access
  • Must possess strong computer skills to utilize MS Word, Excel and Outlook software, plus knowledge of purchasing applications. Lawson preferred or other major system experience. 

Additional Information:

Job ID: 1302

Status: Full-time, Exempt

MVP Health Care is an Affirmative Action/Equal Opportunity Employer). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency, protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at hr@mvphealthcare.com.

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