PCG is currently seeking a qualified Case Manager. The Case Manager will be responsible for assisting enrollees of a publicly administered Medical Fund on behalf of a state agency. The Case Manager will be charged with helping program recipients, family members, and caretakers navigate healthcare benefits offered through this Fund. The Case Manager will also be responsible for utilizing a case management software system on a day-to-day basis. The purpose of the Fund is to provide a funding source for future health care costs associated with birth?related neurological injuries.
The Case Manager will also assist in development of program policies and procedures, and program improvement processes. The Fund operations include, performing assessments, providing case management services, assisting families and program recipients through prior approval of certain healthcare services, and collaborating with the claims administration team. Successful candidates will be accountable for the full patient care cycle. This position can be remote.
Responsible for helping program recipients, family members, and caretakers navigate healthcare benefits
Assists in the development of program policies and procedures
Responsible for the full patient care cycle.
Assesses, plans, implements, monitors and evaluates actions required to meet the client’s health and human services needed.
Coordinates and provides care that is safe, timely, effective, efficient, equitable, and client-centered
Handles case assignments, draft service plans, review case progress and determine case closure
Travels within the State to conduct periodic in person assessments
Facilitates multiple care aspects (case coordination, information sharing, etc.)
Helps patients make informed decisions by acting as their advocate regarding their clinical status and treatment options
Develops effective working relations and cooperate with medical team throughout the entire case management process
Interacts with patients to keep track of their progress and to ensure satisfaction
Records case information, complete accurately all necessary forms and produce statistical reports
Document all care activity via case management software system
Promotes quality and cost-effective interventions and outcomes
Assesses and addresses motivational and psychosocial issues
Adheres to professional standards as outlined by protocols, rules and regulations
BS degree in related healthcare field
Current and active NY license , certification or registration as a Registered Nurse or Social Worker
2+ years of experience working with pediatrics; experience or educational training in health or social services, preferably including work experience or a practicum that involved the performance of assessments and the development of case management plans.
Preferred Skills and Experience:
Excellent communication, interpersonal and client-facing skills.
Ability to work independently and on a team.
Proven working experience in case management, including as a nurse, medical, mental health care manager or a social worker
Excellent knowledge of case management principles, healthcare management and reimbursement
Previous experience working with case management software
Previous experience with psychological aspects of care
Effective communication skills
Excellent organizational and time management skills
Familiarity with professional and technical emerging knowledge
Problem solving skills and ability to multi-task
Compassionate with teamwork skills
Internal Number: 4585
About Public Consulting Group
Public Consulting Group, Inc. (PCG) provides management consulting and technology services to help public sector education, health, human services, and other government clients achieve their performance goals and better serve populations in need. Founded in 1986 and headquartered in Boston, Massachusetts, PCG has more than 2,200 professionals in 55 offices around the U.S. and in Montreal, UK and Poland. The firm draws on more than three decades of consulting to public sector clients to deliver best-practice solutions and measurable results to state and local public agencies, state-operated facilities, and private providers that do business with government agencies. PCG is committed to a diverse workforce which is a reflection of our clients and the people they serve. Our organizational culture attracts and rewards people who are results-oriented and interested in making an immediate impact on their community as well as their own career.