Large, established managed care organization in Downtown, Manhattan is looking for long term contractors.  These roles have flexible hours within normal business days and times. 

Case Manager, Health Coach

Essential Duties:

Under the supervision of the Manager/Supervisor, assists in the identification of members appropriate for intervention utilizing disease management as the primary intervention and provides disease management services to an assigned caseload.

·        Identifies high risk and/or high cost members through various data sources for the program.

·        Utilizes engagement strategies, to invite and enroll members to participate in DM program.

·        Establishes supportive relationship with enrolled members and assumes ongoing primary responsibility for a discrete caseload of members.

·        Assesses the member's needs and adequacy of existing treatment plan by review of claims data, contact with the member, their provider and other resources.

·        Works with the member and their treatment team to identify and establish attainable goals that positively impact clinical and financial outcomes for member.

·        Provides ongoing monitoring, evaluation, support and guidance in coordinating the member's care.

·        Documents all pertinent information pertaining to member progress and management of care.

·        Plans/coordinates services deemed appropriate and cost effective in conjunction with the medical treatment plan.

·        Submits periodic written reports.

• Presents cases for discussion in case rounds and interdepartmental meetings as necessary.
• Performs related tasks as requested.

·        Responsibilities and duties may be added, changed or deleted at any time, at the discretion of senior department management, formally or informally, either verbally or in writing.