FreedomCare · 1 month ago
Health Home Care Manager (Rochester, NY / Field-based)
FreedomCare is a Healthcare company that is innovating and revolutionizing the way home care is delivered. The Health Home Care Manager will outreach and engage potentially eligible patients, coordinate care based on a comprehensive assessment, and work collaboratively with the patient's care team to develop care plans for patients with chronic diseases.
FitnessHealth Care
Responsibilities
Screen for Health Home functional scale eligibility, conduct initial Health Homes assessments and reassessments of patient needs, including medical, mental health, substance use, financial, housing, and additional support needs
Collaborate with the medical providers and patients to develop, implement, and coordinate Health Homes compliant care plans for patients with chronic diseases, such as diabetes, asthma, congestive heart failure, hypertension, mental health conditions, substance use, and more and document care plan outcomes
Provide direct service to a caseload of chronically ill patients and help them achieve their care plan goals by facilitating referrals, addressing access issues, connecting them to local resources, and developing relationships with healthcare providers
Coordinate patient services and care with pharmacies, insurance companies, hospital discharge planning, family caregivers, and other providers
Provide crisis intervention when needed
Conduct home visits and maintain patient contact and documentation of all services in accordance with Health Homes standards
Maintain patient confidentiality at all times
Qualification
Required
1+ year of health homes, HARP or case management experience (required)
Strong working knowledge of local community resources
Demonstrated ability to work with data reporting, documentation, and outcomes
Strong communication and assessment skills; the ability to relate to patients, their families, and community care providers, along with ability to handle rapidly changing crisis situations
Ability to manage high volume caseloads
Able to express empathy and compassion for the underserved
Experience navigating several data management systems, such as Salesforce
Ability to travel in the field to accompany patients to appointments and meet patients in person when needed
Preferred
Bachelor's degree (preferred)
Bilingual Spanish, strongly preferred
Master's degree is a plus
3+ years of Health Homes experience
3+ years of HARP experience
Benefits
Competitive compensation
Medical benefits
Retirement plans
Wellness programs
Fun company events
Ongoing learning opportunities to grow your career
Company
FreedomCare
As a leading CDPAP provider, FreedomCare helps you reclaim your right to health and happiness
H1B Sponsorship
FreedomCare has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (2)
2021 (1)
Funding
Current Stage
Late StageRecent News
Home Health Care News
2025-06-30
Company data provided by crunchbase