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Job Ref: 107008
Category: Utilization Review and Case Management
Department: MHP CHILDRENS PROGRAM
Location: 50 Water Street, 7th Floor, New York, NY 10004
Job Type: Regular
Employment Type: Full-Time
Hire In Rate: $83,000.00
Salary Range: $83,000.00 - $83,000.00
MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.
MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health Hospitals, the largest public health system in the United States, MetroPlusHealth network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlusHealth has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.
Position Overview
The Children's Behavioral Health Care Manager (BH CM) works in the Children's Special Services Department and provides a hybrid approach, including utilization and case management, to support members aged 0-21 years with complex behavioral, medical, and/or developmental health issues. The Children's BH CM is responsible for conducting utilization and quality management activities in accordance with New York State and MetroPlusHealth Utilization Management policies and procedures for diversionary services including, but not limited to HCBS, AOT, and PROS. The Children's BH CM is also responsible for reviewing and approving Plans of Care and HCBS services in collaboration with the CSS Medical CMs and Foster Care Liaison, as indicated. The Children's BH CM works with Health Home Coordinators, LDSS/VCFA, and community providers to advocate for proper access to comprehensive services and continuation of care.
Licensure and/or Certification Required:
Professional Competencies:
#LI-Hybrid
Full Time
Insurance
$102k-132k (estimate)
05/25/2024
07/24/2024
metroplus.org
NEW YORK, NY
1,000 - 3,000
1994
TALYA SCHWARTZ
$3B - $5B
Insurance