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Clinical Case Manager - Medical Indemnity Fund

Public Consulting Group, Inc. Albany, NY Full-Time
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Staffing Solutions Organization LLC (SSO), a wholly owned subsidiary of Public Consulting Group, is focused on delighting clients with world-class managed staffing and talent consulting services. SSO is committed to a diverse workforce, which is a reflection of our clients and the people they serve.

Clinical Case Manager - Medical Indemnity Fund in Albany, NY
 
Overall Responsibilities:

SSO is currently seeking a qualified Case Manager.  The Case Manager will be responsible for assisting enrollees of a publicly administered Medical Fund on behalf of a state agency. The Case Manager will be charged with helping program recipients, family members, and caretakers navigate healthcare benefits offered through this Fund. The Case Manager will also be responsible for utilizing a case management software system on a day-to-day basis.  The purpose of the Fund is to provide a funding source for future health care costs associated with birth‐related neurological injuries.


The Case Manager will also assist in development of program policies and procedures, and program improvement processes. The Fund operations include, performing assessments, providing case management services, assisting families and program recipients through prior approval of certain healthcare services, and collaborating with the claims administration team. Successful candidates will be accountable for the full patient care cycle. This role requires up to 40% travel (mainly within the New York City metropolitan area.)

 
 Responsibilities:

  • Responsible for helping program recipients, family members, and caretakers navigate healthcare benefits
  • Assists in the development of program policies and procedures
  • Responsible for the full patient care cycle.
  • Assesses, plans, implements, monitors and evaluates actions required to meet the client’s health and human services needed.
  • Coordinates and provides care that is safe, timely, effective, efficient, equitable, and client-centered
  • Handles case assignments, draft service plans, review case progress and determine case closure
  • Travels within the State to conduct periodic in person assessments
  • Facilitates multiple care aspects (case coordination, information sharing, etc.)
  • Helps patients make informed decisions by acting as their advocate regarding their clinical status and treatment options
  • Develops effective working relations and cooperate with medical team throughout the entire case management process
  • Interacts with patients to keep track of their progress and to ensure satisfaction
  • Records case information, complete accurately all necessary forms and produce statistical reports
  • Document all care activity via case management software system
  • Promotes quality and cost-effective interventions and outcomes
  • Assesses and addresses motivational and psychosocial issues
  • Adheres to professional standards as outlined by protocols, rules and regulations

 

Minimum Qualifications:

  • BS degree in related healthcare field
  • Current active license, certification or registration as a Registered Nurse or Social Worker
  • 2+ years of experience working with pediatrics; experience or educational training in health or social services, preferably including work experience or a practicum that involved the performance of assessments and the development of case management plans.

 

 Preferred Skills and Experience:

  • Excellent communication, interpersonal and client-facing skills.
  • Ability to work independently and on a team.
  • Proven working experience in case management, including as a nurse, medical, mental health care manager or a social worker
  • Excellent knowledge of case management principles, healthcare management and reimbursement
  • Previous experience working with case management software
  • Previous experience with psychological aspects of care
  • Effective communication skills
  • Excellent organizational and time management skills
  • Familiarity with professional and technical emerging knowledge
  • Problem solving skills and ability to multi-task 
  • Compassionate with teamwork skills
  • Bilingual English/Spanish
All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, marital status, age, national origin, protected veteran status, or disability.  Staffing Solutions Organization LLC is an e-Verify participant.


Other details

  • Pay Type Salary
  • Travel Required Yes
  • Travel % 40
  • Required Education Bachelor’s Degree
  • Albany, NY, USA
 

Recommended skills

Time Management
Complex Problem Solving
Case Management
Social Work
Communication
Spanish Language
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