Dir Complete Care
Location: New York
Posted on: January 17, 2020
DescriptionThe Director of Care Management at Healthfirst, in
collaboration with the AVP of Care Management, will take
independent ownership for responsibilities and oversight of the
care management for all CompleteCare Members. This will include
providing orientation and supervision to the Care Management Teams
(CMT), their Supervisors and Managers as well as developing
efficient and effective systems that will ensure and maintain a
high level of quality care and compliance.- Provide a high level of
supervision to and management support for Managers , Team
Supervisors and the CMTs to ensure the best individualized care
decisions, adherence to timely assessments and interventions for
each member's changing condition(s).
- Participate in all aspects of personnel management to ensure
appropriate staffing, orientation, support, corrective action,
coaching/training plans and timely performance appraisals.
- Coordinate with Contract Services to ensure an understanding of
the MAP model of care and the care management process.
- Enforce guidelines as mandated by CMS and New York State
regulations, job aides and HF policies. This includes review of
performance audit reports in order to maintain superior and
accurate care data for each member in CCMS.
- Manage patient/client information in a shared network
environment using paperless database modules and archival
- Assist with budget planning, preparation and
- Communicate with families, physicians, community providers and
staff at all levels including the use of motivational
- Additional duties as assignedMinimum Qualifications:
- Licensed RN with Bachelor's Degree from and accredited
- Advanced Degree
- Knowledgeable of Department of Health (DOH) and Center for
Medicare & Medicaid Services (CMS) regulations.
- Experience working with one or more Medicaid managed care plan
products, such as Family Health Plus (FHP), Eastern Benefits System
(EBS) and/or Federal Employee Program (FEP).
- Ability to interact and translate business needs in
presentations and writing matching audience.
- Knowledge and understanding of commercial populations.
- Knowledge of National Committee for Quality Assurance (NCQA)
- Ability to use Microsoft Excel to perform pivot tables,
V-lookups and macros
- Ability to use PowerPoint to design, create hyperlinks, design,
create graphics and convert spreadsheets
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are
considered for positions and are evaluated without regard to mental
or physical disability, race, color, religion, gender, national
origin, age, genetic information, military or veteran status,
sexual orientation, marital status or any other protected Federal,
State/Province or Local status unrelated to the performance of the
If you have a disability under the Americans with Disability Act or
a similar law, and want a reasonable accommodation to assist with
your job search or application for employment, please contact us by
sending an email to careers@Healthfirst.org or calling 212-519-1798
. In your email please include a description of the accommodation
you are requesting and a description of the position for which you
are applying. Only reasonable accommodation requests related to
applying for a position within Healthfirst Management Services will
be reviewed at the e-mail address and phone number supplied. Thank
you for considering a career with Healthfirst Management
EEO Law Poster and Supplement
Keywords: Healthfirst, New York , Dir Complete Care, Other , New York, New York
Didn't find what you're looking for? Search again!