Amida Care · 1 month ago
High Risk Care Manager - Children Focus
New York, NY, US
Full-time
Onsite
Mid, Senior Level
$95K/yr - $120K/yr
3+ years expAmida Care is the largest Medicaid HIV Special Needs Plan in NY, delivering a uniquely effective care model for member health outcomes. The High-Risk Care Manager – Children Focus will be responsible for intensive care management for pediatric and adult members with High-Risk designations, ensuring their complex medical, behavioral, and psychosocial needs are met.
Child CareHealth CarePharmaceutical
Responsibilities
Provide clinical guidance to and share administrative oversight of the Amida Stork program (Pregnant and Neonates Program), including outreach to providers (e.g. obstetricians) and members/heads of household/legal guardians
Provide coordination and accountability in managing the care of pediatric/adolescent members; this cohort includes transgender members under the age of 22 years
Serve as a primary point of coordination/accountability in managing the care of adult High-Risk members, including members with unsuppressed HIV Viral load
Participate in quality initiatives, such as gaps in care (GIC), including outreach to provider and/or members, for recommended screenings, examinations, etc
Facilitate the delivery of services to members, including facilitating referrals to medical, behavioral health and social assistance entities and other services to support wellness and health care compliance
Coordinate access for members to other services such as home health care, Health Home, durable medical equipment (DME), hospice care, pharmaceutical, transportation and family planning
Participate in both internal and external case conferences, which include collaborating as part of multidisciplinary team for high-risk members
Establish effective communication with obstetric, pediatric, and primary care sites, as well as health department and community partners and hold collaborative and interdisciplinary meetings to promote family and child health
Collaborates closely with the Voluntary Foster Care (VFCA) Liaison, who serves as the primary point of contact for members engaged in foster care
Communicate effectively with the health services teams, other departments and external entities
Collaborate with Gender Identity Support Team (GIST) to find and develop culturally sensitive care for members, including trans-informed obstetric care within the Amida Care network for transgender/non-binary (TGNB) members
Assist with transitions of care for members admitted to in-patient facilities
Promptly review and address any crisis situations that arise for any client with supervisory staff, service network and any other required entities
Ensure completion of documented care coordination using the Amida Care authorized platforms
Ensure member confidentiality and adhere to Confidentiality and Health Insurance Portability and Accountability Act (HIPPA) policies and regulations
Perform other duties as assigned
Qualification
Required
NYS Registered Nurse or LPN
Three (3) years' experience in clinical setting and/ or managed care setting
Experience working with children/adolescents with complex care needs
Strong knowledge of Microsoft Office (Outlook, Word and Excel)
Demonstrate understanding and sensitivity to multi-cultural values, beliefs, and attitudes of both internal and external contacts
Demonstrate appropriate behaviors in accordance with the organization's vision, mission, and values
Preferred
Five (5) years' experience in clinical setting and/ or managed care setting
Experience working with people living with HIV/AIDS or serious chronic illness
Experience working with settings treating behavioral health and substance use conditions
Company
Amida Care
Amida Care is an organization providing healthcare, meals, advocacy, research and social services.
51-200 employees
Funding
Current Stage
Growth StageLeadership Team
Doug Wirth
President/CEO
Alex Fontanez
Associate Director of Partnerships & Ombudsman
Recent News
2025-11-19
Company data provided by crunchbase