Care Manager - MLTC Program (Queens) (16-07820) - NY - Kew Gardens, NY
at RCM Health Care Services

Date Posted: 7/24/2020

Job Description

Bilingual Russian

Care Manager

Job Description:
This is an IN HOUSE position and based in  the Bronx.
Contact and complete at least a monthly care management note summarizing care given for the month.
Monitor any hospitalizations or ER visits since last contact call/note
Update and changes in medications or treatments as necessary
Follow up with member the use of preventive services covered by the plan
Follow up on DME requests and order delivery status
Review 6 month SAAM reassessments & identify any changes in status and SAAM score
Coordinate Medicare benefits for dual eligible population
Assist with MD appointments and follow up procedures needed
Coordinating hospital and SNF admissions/discharges with facility
Coordinate with CHHA weekly with members utilizing Medicare max
Reviews and completes grievances and complaints that come in through member services
Sends out Notice of Action letters within the appropriate timeframes
Completes disenrollment forms processes and follows up with HRA status.
Other duties as assigned.

Job Snapshot

  • Employee Type: Full-Time
  • Location: Queens, NY
  • Job Type: Management
  • Experience: Not Specified
  • Date Posted: 7/24/2020

About Us

RCM Health Care Services offers career defining opportunities to candidates from the leading employers in health care. Whether you’re looking for a new job or seeking to hire the best medical talent, RCM Health Care Services has the solution for you. Since 1975, we’ve established ourselves as a leader in the recruitment industry by connecting thousands of healthcare professionals with placements that support their needs. If you’re looking to make the next move in your career, let RCM be your guide, we’re with you every step of the way!

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