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Professional, Case Manager

Company: MVP Health Care
Location: Rochester
Posted on: March 19, 2023

Job Description:

Job Description:

Professional, Case Manager Headquarters Office, 625 State Street, Schenectady, New York, United States of America Rochester Office, 220 Alexander Street, Rochester, New York, United States of America Tarrytown Office, 303 South Broadway, Tarrytown, New York, United States of America Req #1277 Monday, December 5, 2022 Over 35 years strong and fueled by 1,700 smart, passionate employees across New York state and Vermont, MVP is full of opportunities to grow. We are a nationally recognized, award-winning leader for a reason. The beating heart of our company is a wide range of employees from a diverse set of backgrounds-tech people, numbers people, even people people-working together to make health insurance better. If you are ready to join a thriving, mission-driven company where you can create your own opportunities and make a positive difference-it's time to make a healthy career move to MVP! There are some positions at MVP where your work may require an onsite or community component. When working in an MVP office and/or in the community on behalf of MVP, you must be fully vaccinated against COVID-19, and have received the first booster dose within one month of eligibility. Full-Time, Exempt SUMMARY: 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 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 to provide appropriate education, resources, and healthcare coaching. The principal 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, including but not limited to Medicaid and Medicare benefits. The overall objective is to create solutions to overcome barriers to care and assist members to 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. This position may be worked virtually (remotely from home) within a New York or Vermont residency. Occasional (semi-annual) travel to the Schenectady based headquarter office is required. POSITION QUALIFICATIONS: Current New York State Licensure as a Registered Nurse is required. Possession of Vermont licensure is preferred but can be obtained post-hire. RN with multiple state licenses is preferred. Bachelor's degree in nursing preferred. Case Management Certification preferred (ANCC or CCM). Minimum Experience: At least 3 years of recent clinical and Case Management experience. Experience with Medicaid and Medicare programs and benefits strongly preferred. Certification in Case Management required within 24 months after hire. Required Skills: 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 care coordination, and quality of care. Must demonstrate understanding of clinical and psychosocial issues that may alter treatment or the care plan. Ability to demonstrate strong judgment when dealing with emotionally charged situations. Strong computer skills including working knowledge of Windows and internet-based applications. About MVPMVP Health Care is a nationally recognized, not-for-profit health insurer caring for more than 700,000 members in New York and Vermont. Committed to the complete well-being of our members and the communities we serve, MVP makes health insurance more convenient, more supportive, and more personal. We are powered by the ideas and energy of more than 1,700 diverse, employees from all backgrounds, committed to having a positive impact on the health and wellness of everyone we serve. MVP Health Care is an Affirmative Action/ Equal Employment Opportunity (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), and the Know your Rights 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 Please apply and learn more - including how you may become a proud member of our team. Other details Job Family Medical Management/Clinical Pay Type Salary

Keywords: MVP Health Care, Rochester , Professional, Case Manager, Executive , Rochester, New York

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