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Clinical Care Manager (AIM Program)

Manhattan, New York Care Management
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Job ID R010616

Our clinical care management services are anchored in evidence-based practices to optimize the utilization of healthcare benefits and services. We are dedicated to delivering personalized care that empowers patients to safely manage their health within the comfort and security of their own homes and communities.


$93,400.00 - $116,800.00 Annual

 What We Provide 

  • Attractive sign-on bonus and referral bonus opportunities    
  • Generous paid time off (PTO), starting at30 days of paid time offand 9 company holidays  
  • Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability   
  • Employer-matched retirement saving funds  
  • Personal and financial wellness programs   
  • Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care    
  • Generous tuition reimbursement for qualifying degrees  
  • Opportunities for professional growth and career advancement   
  • Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities     

What You Will Do

  • Coordinates and/or oversees the coordination of benefits and services for all members on his/her caseload.

  • Completes care management and disease specific assessments.

  • Makes timely telephonic care management calls based on risk level.

  • Resolves and coordinates complex issues and member complaints impacting the delivery of services.

  • Provides health education to member/caregiver.

  • Assess SDoH and provide care coordination to reduce/remove barriers of care to include ability to allow for changing levels of care based on assessments, trigger events and program data/reports.

  • Identifies member safety issues and intervenes as necessary or refers to appropriate resources, such as community linkages, dietary, therapy (PT/OT/ST), HHA services, behavioral health, and DME.

  • Coordinates the delivery of high quality, cost-effective care based on a customized population model of care supported by evidence based clinical practice guidelines.

  • Advocates for the member/caregiver to obtain the health care and other services needed to optimize their quality of life.

  • Utilizes the Care Management process to set priorities, plan, organize and implement interventions that are goal directed towards self-care outcomes and the transition to independent status.

  • Promotes adherence to the physician treatment plan by providing education, coaching and support.

  • Educates, coordinates, and provides resources to reduce inappropriate utilization of emergency room (ER) and hospital service.

  • Increases utilization of primary care, specialty care, preventive health and guideline-based treatments including proper pharmacotherapy within network, as appropriate.

  • Participates in interdisciplinary team (IDT) meetings and provide input on customer service-related activities.

  • Protects the confidentiality of member information and adheres to company policies regarding confidentiality.

  • Ensures compliance with payors’ policies and procedures as well as all Federal and State regulations.

  • Interprets and implements VNS Health policies, state and federal regulations.

  • Participates in special projects and performs other duties as assigned.

For AIM, only:

  • Initiates conversations with the home care team regarding the potential need for Hospice and Palliative Care.

  • Reviews VNS Health patient records for cases that were readmitted during an active home care episode.

  • Identifies potential barriers to Hospice and Palliative Care; follows up with clinical operations to communicate identified barriers and recommended interventions, as appropriate.

  • Participates in internal and external clinical case review meetings for select patient populations, as needed. Maintains excellent communication and relationships with home care and hospice teams.

  • Reviews VNS Health patient records for cases that were readmitted during an active home care episode.  Participates in the root cause analysis of the readmission event in collaboration with VNS Health operations and helps to develop recommendations for quality improvement measures.

  • Associated degree in nursing or a bachelor’s degree in physical therapy required.
  • Minimum two years of experience as a registered nurse
  • License and current registration to practice as a Registered Professional Nurse or Physical Therapist or Occupational Therapist in the State of New York required.
  • Population Care Coordination Certification preferred.
  • Care Management, Case Management, OASIS or other application certification preferred.

About Us

VNS Health is one of the nation’s largest nonprofit home and community-based health care organizations. Innovating in health care for more than 125 years, our commitment to health and well-being is what drives us—we help people live, age and heal where they feel most comfortable, in their own homes, connected to their family and community. On any given day, more than 10,000 VNS Health team members deliver compassionate care, unparalleled expertise and 24/7 solutions and resources to the more than 43,000 “neighbors” who look to us for care. Powered and informed by data analytics that are unmatched in the home and community-health industry, VNS Health offers a full range of health care services, solutions and health plans designed to simplify the health care experience and meet the diverse and complex needs of the communities and people we serve in New York and beyond.

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Organizational Structure

At VNS Health, we drive and support a culture of innovation by providing team members with the tools and resources to explore innovative ideas on their own. In addition to being a healthcare services organization, we are on the… [more]

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Mission & Values

As a team member of VNS Health, you share a passion for improving the health of patients through best-in-class care in the home and the community.

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Inclusive Culture

At VNS Health, our priority is to create an environment where every team member feels they belong and are included.

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Total Rewards

We provide our team members a well-rounded employment experience, competitive compensation, and a robust and affordable benefits package that serves you and your family. Our Total Rewards Program at VNS Health is an investment in your health, wealth and life.

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