Care Manager 

Job Description

This is an IN HOUSE position and based in  the Bronx.

Contact and complete at least a monthly care management note summarizing care given for the month. Monitor any hospitalizations or ER visits since last contact call/note Update and changes in medications or treatments as necessary 
Follow up with member the use of preventive services covered by the plan
Follow up on DME requests and order delivery status

Review 6 month SAAM reassessments & identify any changes in status and SAAM score

Coordinate Medicare benefits for dual eligible population

Assist with MD appointments and follow up procedures needed

Coordinating hospital and SNF admissions/discharges with facility

Coordinate with CHHA weekly with members utilizing Medicare max

Reviews and completes grievances and complaints that come in through member services

Sends out Notice of Action letters within the appropriate timeframes

Completes disenrollment forms processes and follows up with HRA status.

Other duties as assigned.