Apply Now

Case Management, Professional, Case Manager

Headquarters Office, Schenectady, New York, United States of America, Rochester Office, Rochester, New York, United States of America Req #215
Friday, August 9, 2019
Be a part of the transformation at MVP Health Care®. MVP Health Care is a nationally-recognized, regional not-for-profit health insurer. We care for more than 700,000 members across New York and Vermont and are powered by the ideas and energy of more than 1,700 employees. We employ talented people  with diverse backgrounds and experience—tech people, numbers people, even people people—to make health insurance more convenient, more supportive, and more personal. If you’re ready to join a thriving, mission-driven company where you can create your own opportunities—it’s time to make a healthy career move to MVP.

Status: Full-time, Exempt: Yes


This position 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.


POSITION QUALIFICATIONS


Minimum Education:

Current New York State Licensure as a Registered Nurse

Bachelor's degree in nursing preferred

Case Management Certification a Plus (ANCC or CCM)


Minimum Experience:

At least 3 years of recent clinical and Case Management experience

Pediatric experience preferred

Certification in Case Management required within 24 months after hire


Required Skills:

•Ability to professionally communicate 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


 


MVP Health Care is an Affirmative Action/Equal Opportunity Employer (PDF). 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 (PDF), 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.

Other details

  • Job Family Medical Management/Clinical
  • Pay Type Salary
  • Headquarters Office, Schenectady, New York, United States of America
  • Rochester Office, Rochester, New York, United States of America