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Care Manager - MLTC Program (Queens)
Ref No.: 16-07820
Location: Kew Gardens, NY, New York
Bilingual Russian

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.