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Care Manager of Health Home Care

Sun River Health
Monticello, NY Full Time
POSTED ON 3/27/2026
AVAILABLE BEFORE 5/25/2026

Sun River Health provides the highest quality of comprehensive primary, preventative and behavioral health services to all who see it, regardless of insurance status and ability to pay, especially for the underserved and vulnerable. Sun River Health is a Federally Qualified, Non-Profit Health Center serving communities in Suffolk, Rockland, Orange, Dutchess, Ulster, Sullivan, Columbia and Westchester County. Sun River Health is currently seeking a full-time Care Manager to join our team in Monticello, New York.

The Care Manager has overall day-to-day responsibility for coordinating the activities of the care team for patients with complex medical and psychosocial needs and for facilitating each patient’s access to the full range of medical and psychosocial services in an efficient and effective manner.

****** $1500 Sign On Bonus- Terms and Conditions Apply****

Essential Duties and Responsibilities of a Care Manager:

  • Works closely with the interdisciplinary care team including the PCP, mental health provider, residential services, substance abuse provider, etc. in the development and ongoing coordination of the care plan.
  • Works closely with the Patient Navigator to direct field activity as needed and ensure the flow of information across and between the care team is optimized.
  • Provides input to providers/patient/family for written individualized care plans.
  • Reviews patient intake assessments and uses results to coordinate the completion of the care plan, self-management goals and strategies.
  • In conjunction with the patient, identifies potential barriers to care and helps patient identify ways to overcome those barriers; reaches out to patients who have not met treatment goals to resolve barriers/adjust goals when possible.
  • Evaluates medication compliance and assesses potential barriers to adherence; ensures medication reconciliation is current.
  • Receives alerts to inpatient and ER admissions. Visits patients during inpatient stays and participates actively in discharge planning and care transition activities.
  • Contacts patients after discharge from inpatient services and ER within one business day.
  • Reaches out to patients to help them keep scheduled appointment; arranges for appropriate metabolic and periodic preventive screening in accordance with agency policy.
  • Ensures that patients and care givers are aware of test results by facilitating discussions between the patient and physician as necessary.
  • Coordinates services between patient and extended care team providers to ensure that integrated care plan is fully implemented.
  • Regularly reviews workload report in TREAT to identify patients requiring, assessments outreach and engagement.
  • Provides or arranges for provision of self-management/ wellness education, peer and other support groups in the language that the patient/family prefers.
  • Organizes and participates in case conferences as per patient need and in accordance with agency policy
  • Reviews benefits, entitlements, housing with the patient/family and assists in the application process. Follows up as necessary to ensure services are approved.
  • Utilizes the TREAT system to complete all documentation and assessments timely including scheduling of all activity.

Minimum Education Requirement: High School diploma/ GED
Preferred Education Requirement: Bachelor’s degree in Health or Human Services related field
Minimum Work Related Experience: 2 years

Sun River Health is a network of over 40 Federally Qualified Health Centers (FQHCs) providing primary, dental, pediatric, OB-GYN, and behavioral health care to over 245,000 patients annually. With a dedicated staff of 2,000 doctors, nurses, and health care professionals, we pride ourselves on delivering high-quality, affordable care to those who need it most. Sun River Health started in 1975 when four African American mothers spearheaded efforts to open our first health center in Peekskill, New York to deliver accessible, high-quality, affordable services to patients in need no matter their race, religion, income, or insurance status. Today, after 45 years of service, Sun River Health is still delivering on that promise to communities across the Hudson Valley, New York City, and Long Island.

Job Type: Full-time

Salary: $23.00 - $25.80 per hour

About Sun River Health

Sun River Health has a rich history of providing quality, affordable health care to communities in need. Founded in the early 1970s by four African American women in Peekskill, New York, the organization was established to address the lack of accessible health services in their community. With the help of a small federal grant, the first Sun River Health site opened its doors in 1975. Over the years, Sun River Health has grown into a comprehensive Federally Qualified Health Center (FQHC) system with over 45 locations, serving more than 250,000 patients across the Hudson Valley, New York City and Long Island. Our exceptional primary care practitioners, specialists and support staff are dedicated to delivering high-quality care to all individuals, regardless of their ability to pay. In December 2018, Sun River Health expanded its reach by merging with Brightpoint Health, an FQHC network offering integrated medical, behavioral and social support services in New York City. This merger allowed us to enhance our services and continue our mission under the unified name of Sun River Health.

Our Culture

At Sun River Health, we believe in fostering a culture of wellness, inclusivity and recognition. Our Workforce Wellness Program promotes staff wellness through ongoing challenges and activities, encouraging participation and rewarding engagement. We celebrate our staff's dedication and person-centered spirit through the Planetree Recognition Awards, which honor innovation, leadership and community spirit. We are committed to creating a supportive and collaborative work environment where all team members can thrive. Our values of respect, integrity and excellence guide our interactions with patients and colleagues alike, ensuring that everyone receives the care and support they deserve.

Benefits

At Sun River Health, we are committed to building a personal relationship with our team and supporting you in every way we can. We offer competitive compensation and a comprehensive benefits package for you and your family, including:

  • Medical, Dental and Vision Insurance: Comprehensive health coverage to ensure you and your family stay healthy.
  • Life and Disability Coverage: Financial protection for you and your loved ones in case of unforeseen circumstances.
  • Retirement Savings Plan: Plan for your future with our retirement savings options.
  • Commuter and Transit Benefits: Assistance with your daily commute to make your journey to work easier.
  • Employee Assistance Program (EAP): Access to confidential support and resources for personal and work-related issues.
  • Employee Discount Program: Enjoy discounts on various products and services as a valued member of our team.
  • Provider Incentive Compensation Program: Quality & Productivity.
  • Professional License, Certification and DEA Fees Reimbursement.

Why Join Sun River Health?

  • Mission-Driven Work: Be part of a proud network of care that offers high-quality health and social support services to communities in need.
  • Professional Growth: We provide opportunities for career advancement and professional development.
  • Supportive Environment: Our culture promotes wellness, inclusivity, and recognition, ensuring a supportive and collaborative work environment.
  • Community Impact: Make a difference in the lives of individuals and families by providing quality, affordable health care.

Join us at Sun River Health and be part of an award-winning network of care that has been serving our communities since 1975. We are always looking for skilled and dedicated professionals to join our team and help us continue our mission of providing quality health care to all.

Job Type: Full-time

Pay: $23.00 - $25.80 per hour

Benefits:

  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Employee assistance program
  • Flexible spending account
  • Health insurance
  • Health savings account
  • Life insurance
  • Paid time off
  • Referral program
  • Retirement plan
  • Vision insurance

Education:

  • High school or equivalent (Required)

Work Location: In person

Salary : $23 - $26

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