Company Statement
EmblemHealth is one of the nation’s largest not for profit health insurers, serving members across New York’s diverse communities with a full range of commercial and government-sponsored health plans for employers, individuals, and families. With a commitment to value-based care, EmblemHealth partners with top hospitals and doctors, including its own AdvantageCare Physicians, to deliver quality, affordable, convenient care. At over a dozen EmblemHealth Neighborhood Care locations, members and non-members alike have access to community-based health and wellness guidance and resources. For more information, visit emblemhealth.com.
Care Manager, LTSS Enrollment - Remote/NYC
Education, Training, Licenses, Certifications
- Bachelor’s degree.
- RN required, with current active RN license
- CCM certification preferred
Relevant Work Experience, Knowledge, Skills, and Abilities
- 4 – 6+ years of clinical experience. (R)
- 5+ years of experience in care/case management, population health management, utilization review, quality assurance, or discharge planning (preferably within a managed care, home care, or community health organization. (R)
- Experience in case management/care coordination, managed care, and/or utilization management. (R)
- Additional experience/specialized training may be considered in lieu of Bachelor’s degree. (R)
- Experience with NYSDOH Medicaid program requirements and benefits under Long Term Care Proficiency in utilizing and analyzing UAS-NY assessments and assessment outcomes. (R)
- Organization/prioritization ability; and the ability to effectively manage a caseload of highly complex members. (R)
- Experience with Long-term Services and Supports (LTSS), Managed Long Term Care (MLTC). (R).
- Strong communication skills (verbal, written, presentation, interpersonal). (R)
- Computer proficiency: MS Office (Word, Excel, Powerpoint, Outlook); mobile technology (wireless phone/laptop, etc.). (R)
- System user experience in a highly automated environment. (R)
- Bilingual ability (verbal, written). (P)
- Strong cross-group collaboration, teamwork, problem solving, and decision-making skills. (R)
- Ability to work a flexible schedule (evenings, weekends and holidays) to meet member and/or caregiver and departmental scheduling needs. (R)
Security Disclosure
If you receive a job offer from EmblemHealth, the email will be from “HRTalentAcquisition” with the subject: “Offer of Employment for (job title) – Please respond online.” We will never ask you to join a Google Hangout, buy your own equipment, or pay to apply. We also do not use third-party email services like Yahoo or Gmail.
Pay Disclosure
At EmblemHealth, we prioritize transparency in our compensation practices. We provide a good faith estimate of the salary range for potential hires, which is based on key factors such as role responsibilities, candidate experience, education and training, internal equity, and market conditions. Please be aware that this estimate doesn’t account for geographic differences related to your work location. Typically, new hires may not start at the top of this range, as compensation is tailored to each individual's circumstances. For union positions, salaries will be determined according to the collective bargaining agreement. Join us at EmblemHealth, where your contributions are valued and supported by fair compensation.
EEOC Statement
We value the diverse backgrounds, perspectives, and experiences of our workforce. As an equal opportunity employer, we consider all qualified applicants for employment regardless of race, color, religion, sex, sexual orientation, gender identity, pregnancy, marital status, national origin, disability, veteran status, or any other protected characteristic protected by law.
Sponsorship Statement
EmblemHealth may provide work visa sponsorship depending on factors such as business unit requirements, position nature, costs, and applicable laws and regulations.