**Duties/Responsibilities:** + Advocates, informs, and educates beneficiaries on services, self-management techniques, and health benefits. + Conducts assessments to identify barriers and opportunities for intervention. + Develops care plans that align with the physicians treatment plans and recommends interventions that align with proposed goals. + Generates referrals to providers, community-based resources, and appropriate services and other resources to assist in goal achievement. + Collaborates with provider doctors, social workers, discharge planners, and community based service providers to coordinate care accordingly. + Coordinates and facilitates with the multi-disciplinary health care team as necessary in order to ensure care plan goals are achieved and maximize member outcomes. + Assists in identifying opportunities for alternative care options based on member needs and assessments. + Evaluates service authorizations to ensure alignment and execution of the members care and physician treatment plan. + Contributes to corporate goals through ongoing execution of member care plans and member goal achievement. + Documents all encounters with providers, members, and vendors in the appropriate system in accordance with internal and established documentation procedures; follows up as needed; and updates care plans based on member needs, as appropriate. + Occasional overtime as necessary. + Additional duties as assigned. **Minimum Qualifications:** + NYS RN or + LCSW, LMSW, LMFT, LMHC, LPC, licensed psychologist (any state) **Preferred Qualifications:** + Strong interpersonal and assessment skills, especially the ability to relate well with seniors, their families, and community care providers, along with demonstrated ability to handle rapidly changing crisis situations. + Fluency in Spanish, Korean, Mandarin, or Cantonese. + Knowledge and experience with the current community health practices for the frail adult population and cognitive impaired seniors. + Knowledge of InterQual and LOCADTR. + Experience managing member information in a shared network environment using paperless database modules and archival systems. + Experience and knowledge of the relevant product line + Relevant work experience preferably as a Care Manager + Demonstrated ability to manage large caseloads and effectively work in a fast-paced environment + Proficient with simultaneously navigating the Internet and multi-tasking with multiple electronic documentation systems + Experience usingMicrosoft Excel with the ability to edit, search, sort/filter and other Microsoft and PHI systems