Care Manager PCC

About This Role

The Care Manager partners with individuals with intellectual and developmental disabilities (I/DD), their families, and providers to coordinate care and services. This role ensures individuals achieve optimal health, wellness, independence, and community integration by providing comprehensive care management and coordination.

Responsibilities

• Conduct comprehensive assessments to identify an individual’s clinical and psychosocial needs, choices, and preferences for services
• Assess and address health and safety issues as well as barriers to care and treatment including social determinants of health
• Collaborate with interdisciplinary teams and incorporate input into comprehensive assessments and person-centered Life Plans
• Facilitate, develop, and maintain person-centered Life Plans that integrate an individual’s personal wants and needs, clinical and non-clinical healthcare related needs, community services, OPWDD services, and natural supports
• Incorporate health promotion and support opportunities for individuals to achieve and maintain optimal health and wellbeing
• Adhere to Incident Management regulations, guidelines, and policies and procedures
• Coordinate and ensure access to chronic disease management
• Facilitate referrals to clinical and community resources, including planning, implementation, and follow-up for comprehensive care management and transitional care
• Participate in internal and external audits
• Coordinate and provide access to long-term care supports and services
• Engage families and natural supports in the care coordination process
• Provide culturally and linguistically appropriate services to all individuals and families
• Advocate on behalf of the individual and promote self-advocacy and self-direction
• Utilize Health Information Technology for documentation, linking services, and facilitating communication among the care coordination team
• Secure all health records and other protected information with the highest regard to confidentiality and HIPAA laws and regulations

Requirements

• Ability to act quickly, assess and act accordingly in crisis situations
• Intermediate technology skills in Outlook, Teams, Word, Excel, online applications
• Understanding use of an EHR system
• Knowledge of ethical and professional responsibilities and boundaries
• Demonstrate professional work habits including dependability, time management, organization, autonomy, and productivity
• Valid driver’s license
• Ability to travel throughout covered territories in Upstate NY as needed

Qualifications

• Bachelor’s degree with two years of relevant experience OR A license as a Registered Nurse with two years of relevant experience OR A Master’s degree with one year of relevant experience
• 2 years of relevant experience with a Bachelor's or RN license, or 1 year with a Master's degree.

Nice to Have

• Bi-lingual skills

Skills

* Required skills