Provides care coordination and non-clinical support functions to PHP participants in accordance with PHPs’ model of care, CMS’s and NYSDOH’s contractual managed care agreements. Member of a two-person team responsible for assisting clinically licensed care managers in the full continuum of activities, including assessments, care and service planning and ongoing monitoring and coordination for Plan Participants enrolled in PHP.
Duties and Responsibilities:
- Serve as the single point of contact for care coordination and management for PHP participants;
- Assist Care Manager with member assessments, including conducting CQL interviews and other member documents;
- Assist in the development of Life Plans with members and in collaboration with IDT;
- Coordinate implementation and monitoring of Life Plans including integration of all supports and services and equipment;
- Link and refer members to service providers and activities, including community resources;
- Alert Care Manager regarding any emerging physical or behavioral health issues;
- Attend and assist facilitation at IDT meetings;
- Coordinate/schedule all member meetings, appointments, and transportation as needed;
- Provide visits to members’ homes as needed;
- Provide assistance in orientation and education to members, families, IDT and other providers and stakeholders;
- Flexibility with work schedule, including evening and weekend hours may be required as needed;
- Adhere to all required timeframes for member telephonic and in person contacts, assessments, life plan meetings and follow up to ensure the effectiveness of care and service plans;
- Provide all verbal, written and electronic communication with members/caregivers/families, IDT, providers and vendors in a timely manner and document accordingly;
- Provide timely preparation and completion of all data entry, data collection, report production, and monthly service notes;
- Assist members with maintaining and applying for benefits and entitlements such as Medicaid Spend Down, Food Stamps, HEAP, etc.;
- Comply with all requirements of the PHP model of care including the electronic record system, member alerts and service reports, and state and federal requirements;
- Practice and promote PHPs’ mission and values;
- Utilize a person-centered approach and support members to be as self-directed as possible, and
- Perform all other duties as assigned.
- Bachelor’s degree in relevant field with a minimum of (1) year of work experience with persons with intellectual and other development disabilities required, (QIDP);
- Excellent interpersonal, communication and organizational skills along with attention to detail required;
- Working knowledge of Microsoft Word and Excel in a windows environment required;
- Excellent follow-up and problem resolution skills also required;
- Proficiency with health-related computer applications desired;
- Valid Driver’s License to travel within NYS preferred, and
- Must be able to travel as necessary and adhere to PHP’s travel polices.
Requirements of All Positions:
- All employees shall meet PHP’s Compliance and Privacy Regulations, and attend at a minimum of one (1) hour of Compliance and Privacy educational training annually;
- All employees shall master PHP’s Model of Care and complete all training requirements within the first thirty (30) days of employment and annually thereafter, or as required by state and federal regulations;
- All employees are required to maintain confidentiality, protect privacy, comply with Protected Health Information regulations, and report violations;
- Perform functions as they relate to “Improving Health Care Quality” as defined in the National Association of Insurance Commissioners Supplemental Health Care Exhibit that:
1. Improve health outcomes;
2. Prevent hospital readmission;
3. Improve patient safety and reduce medical errors, and
4. Provide wellness and health promotion activities.
Physical Demands and Work Environment:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this position, the employee is regularly required to talk or hear. The employee frequently is required to use hands or fingers, handle or feel utilize objects, tools or controls. The employee is occasionally required to stand; walk; sit; reach with hands and arms; climb or balance; and stoop, kneel, crouch or crawl.
The employee must occasionally lift and/or move up to 25 pounds, and infrequently up to 50 pounds. Specific vision abilities required by this position include close vision, distance vision, color vision, peripheral vision, and the ability to adjust focus. The noise level in the work environment is usually moderate.
Equal Opportunity Employer