Housing Works
HH+ Care Manager (Spanish Speaking Preferred)
Compensation $52,000 - $55,000 commensurate with experience. Spanish bilingual proficiency is preferred; candidates hired to support clients in Spanish are eligible for additional compensation.
Overview Health Home Plus (HH+) is a model within the Housing Works Health Home Care Coordination program that provides a higher level of care for specialized populations (SMI and HIV+) of Health Home members. The higher level of care is supported by specific caseload ratios, level of service provision, staff qualifications, and staff training. HH+ Case Manager works with members and the member’s network of providers to help minimize barriers to care and help members achieve improved health outcomes using interventions such as care coordination, motivational interviewing, and health promotion. HH+ Case Managers help members over time develop the skills needed to manage their health and psychosocial needs with greater independence and work as part of an outcome driven integrated team.
Responsibilities
The HH+ Care Manager is responsible for assessing a member’s needs and coordinating with the member, member’s family, and network providers to develop and execute an Individualized Plan of Care.
Maintain documentation and update assessments and plan of care at specific time intervals or as needed in Housing Works and Health Home electronic medical records system.
Work and communicate effectively with interdisciplinary team of providers, including primary care provider, psychiatrist, therapist, substance abuse treatment programs, and other providers.
Schedule and attend integrated case conferences every 90 days.
Work with the member to identify barriers to goal attainment and help resolve those barriers, i.e., keeping scheduled appointments with appropriate service providers medication regimen for adherence while promoting optimal health.
Conduct field work to member’s home and other provider settings as needed to fulfill plan of care.
Coordinate transitional care from an inpatient service to other settings as per the agreed upon plan.
Work collaboratively with team members to provide outreach and engagement to hard-to-reach members.
Seniority Level Entry level
Employment Type Full-time
Job Function Health Care Provider
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Overview Health Home Plus (HH+) is a model within the Housing Works Health Home Care Coordination program that provides a higher level of care for specialized populations (SMI and HIV+) of Health Home members. The higher level of care is supported by specific caseload ratios, level of service provision, staff qualifications, and staff training. HH+ Case Manager works with members and the member’s network of providers to help minimize barriers to care and help members achieve improved health outcomes using interventions such as care coordination, motivational interviewing, and health promotion. HH+ Case Managers help members over time develop the skills needed to manage their health and psychosocial needs with greater independence and work as part of an outcome driven integrated team.
Responsibilities
The HH+ Care Manager is responsible for assessing a member’s needs and coordinating with the member, member’s family, and network providers to develop and execute an Individualized Plan of Care.
Maintain documentation and update assessments and plan of care at specific time intervals or as needed in Housing Works and Health Home electronic medical records system.
Work and communicate effectively with interdisciplinary team of providers, including primary care provider, psychiatrist, therapist, substance abuse treatment programs, and other providers.
Schedule and attend integrated case conferences every 90 days.
Work with the member to identify barriers to goal attainment and help resolve those barriers, i.e., keeping scheduled appointments with appropriate service providers medication regimen for adherence while promoting optimal health.
Conduct field work to member’s home and other provider settings as needed to fulfill plan of care.
Coordinate transitional care from an inpatient service to other settings as per the agreed upon plan.
Work collaboratively with team members to provide outreach and engagement to hard-to-reach members.
Seniority Level Entry level
Employment Type Full-time
Job Function Health Care Provider
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