CDPHP HARP RN Case Manager in Albany, New York

For more than 30 years, CDPHP has been providing outstanding health care coverage in the Capital Region of New York and beyond. Based in Albany, NY, the physician-guided not-for-profit offers plans in 24 counties. CDPHP cares deeply about the health and well-being of its members as well as its employees. The company values integrity, diversity, and innovation, and its corporate culture supports those values wholeheartedly. At CDPHP, the employees have a voice and are encouraged to make an impact at both the company and community levels through engagement and volunteer opportunities. CDPHP invests in employees who share these values and invites you to be a part of that experience.

A Case Manager is responsible for assisting HARP members identified at risk for recidivism, discontinuous care, or as members or priority or special needs populations who present with complex needs for coordination of their behavioral health service with other aspects of their care. The HARP Case Manager is responsible for assisting these assigned members to care at all levels pf the continuum, and for providing any and all required field visits, discharge coordination; referrals to care plan of care development and care coordination as needed. The Case Manager executes these responsibilities consistent with the applicable CDPHP’s policies and procedures. A HARP Case Manager represents the organization to providers, member groups and families, and participates in the overall administration of clinical operations as warranted.

The HARP Case Manager is expected to being a level of clinical leadership to the case management department. These case managers are specifically chosen based upon a targeted area of practice, supported by education, training and experience, with expertise in the delivery of behavioral health care to a given population. In addition, a case manager may serve as the case management lead for other members of his/her team. Case managers are responsible to meet with members in their homes, hospitals and other outpatient settings.

QUALIFICATIONS:

  • Associates degree required. Bachelor’s degree preferred.

  • Registered Nurse with a current New York State license is required.

  • Certification in substance use disorders helpful.

  • A minimum of 3 years clinical experience is required.

  • Experience in managed care strongly preferred.

  • Experience with chronic condition management, particularly diabetes and heart disease is required.

  • General knowledge of best practices in behavioral health, emphasizing work with special needs or priority populations and in public sector systems.

  • Certification in substance use disorders helpful. Behavioral health experience preferred.

  • Case management experience and CCM certification preferred.

  • Ability to provide case management for complicated members with multiple comorbidities and chronic diseases is required.

  • Demonstrated ability to work with diverse population is required.

  • Demonstrates: excellent clinical, written and oral communication skills, knowledge of clinical treatment, case management, and community resources.

  • Demonstrated ability to influence others while motivating them to change is required.

  • Ability to communicate effectively with members with varying levels of education, health literacy and understanding is required.

  • Demonstrated ability to interact with provider, members to positively impact the quality of patient care required.

  • Proven customer service skills are required.

  • Ability to foster teamwork as an attitude and a skill is required.

  • Demonstrated ability to review health care delivery against established criteria required.

  • Ability to manage multiple projects in conjunction with patient caseload is required.

  • Demonstrated PC skills experience is required.

  • Working knowledge of health, social service and funding resources, including community agencies and alternate care delivery systems is required.

  • Access to reliable transportation to all CDPHP service areas to deliver service to members during regular business hours, evenings and possibly weekends is required.

  • Ability to represent CDPHP in a professional and positive manner is required.

  • Valid driver's license and driving record showing no restrictions that would impede ability to travel by automobile required.

  • Flexibility to travel to a variety of sites across CDPHP service area required.

  • Spanish speaking preferred.

As an Equal Opportunity / Affirmative Action Employer, CDPHP will not discriminate in its employment practices due to an applicant’s race, color, creed, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship, physical and mental disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, a disabled, special, recently separated, active duty wartime, campaign badge, Armed Forces service medal veteran, or any other characteristics protected under applicable law.