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Whitney M. Young, Jr. Health Center · 5 hours ago

Health Home Program Manager - ADULT/HARPS (Req 101037)

Albany,NY,US

Full-time

Onsite

Mid, Senior Level

$63K/yr - $68K/yr

2+ years exp

Whitney M. Young, Jr. Health Center is dedicated to providing high quality healthcare that is affordable and accessible to a diverse community. The Health Home Care Coordination Program Manager oversees daily operations of the Health Home serving ADULTS/HARPS, ensuring effective care coordination and compliance with health regulations.

DentalHealth CareMedicalNon Profit

Responsibilities

Provides program oversight and supervision for Health Home Care Coordinators serving the ADULT/HARPS population, including staff development and required training

Provides oversight for internal/external referrals

Facilitates care manager admission process for the health home serving ADULTS/HARPS, ensuring timely and appropriate case assignments

Ensures timely completion of Specialty HARPS Assessments for all participants

Performs utilization review and chart audits necessary to ensure accurate/complete documentation

Monitors care coordination workflows for ADULTS/HARPS embedment(s) across WYH network of care

Possesses a working knowledge and application of the electronic platforms adopted by the Lead Health Home(s), other DOH reporting systems and WYH- is a super user/trainer for all software utilized for documentation purposes

Monitors care coordination caseloads to ensure stratification and acuity

Facilitates continuity of care meetings with Managed Care Organizations (MCO) regarding high risk, high service utilization for ADULT/HARPS

Submits monthly reporting and documentation as required by the lead health home, DOH and WYH, including but not limited to care manager notes, specialty assessments, plans of care, HML/acuity and HCBS in a timely manner

Facilitates Case Conference for ADULTS/HARPS care team

Serves as the ADULT/HARPS liaison to the Lead Health Home; and conducts capacity reporting and case load stratification

Monitors, reviews and ensures completion of care coordination activities and action boards

Manages patient lists supplied by the Lead Health Home(s) including community- based referrals

Oversees outreach, diligent search and care coordination activities necessary to engage/re-engage patients in the program

Reviews and submits care coordination documentation as to ensure fulfillment of billing in accordance with Medicaid/DOH requirements

Serves as a resource for WYH departments and outside community based organizations to increase referral base and program census

Participates in Team Meetings, Diversion and Coordination of Care meetings and department meetings as assigned

Monitors, reviews and disseminates ADULT/HARPS assignments to ensure care coordinator fulfill of productivity standards

Ensures all patients receive monthly CORE care management services

Demonstrates excellence in both internal and external customer service

Displays an awareness and sensitivity to the diversity of the population served

Understands and is able to articulate HIPAA compliance, corporate compliance, patient confidentiality and DOH 5055

Ensures compliance with local, state, and federal regulation (i.e., Joint Commission, NCQA, NYSDOH, Lead-Health Home)

Adheres to the National Patient Safety Goals as defined by NCQA and Whitney M. Young Jr. Health Services

Completes other duties, as assigned

Qualification

Health Home Care ManagementSupervision of CliniciansSPMIUtilization ReviewCare CoordinationCustomer ServiceHIPAA ComplianceDiversity Awareness

Required

A Bachelor's Degree in a qualifying field and two (2) years of experience working with Serious Persistent Mental Illness (SPMI), Intellectual/Developmental Disabilities (I/DD), or Alcoholism/Substance Abuse (SUD); OR possession of a Credentialed Alcoholism and Substance Abuse Counselor (CASAC) and two (2) years of experience

OR a Bachelor's Degree or higher in ANY related field with either three (3) years of experience, or two (2) years of experience serving as a Health Home Care Manager serving the SMPI population

Preferred

Master's prepared licensed level health care professional in a qualifying field and (1) year of experience supervising clinicians or care coordinators who are providing direct services to individuals with SPMI or SUD