Care Manager

About the role

This Care Manager position sits within MercyFirst’s Integrated Health – Care Management team, reporting to Care Management leadership. The role is hybrid in Brooklyn, NY, with a $1,000 hiring incentive after 500 worked hours.

About MercyFirst

MercyFirst is a not-for-profit human and social service agency founded in 1894 by the Sisters of Mercy/Hermanas de las Misericordia. We serve children, teenagers, and families in Brooklyn, Queens, Staten Island, and across Long Island through prevention and family foster care, community-based group homes, and short-term residential services for unaccompanied migrant children. Each year we help more than 3,000 individuals overcome obstacles and develop their full potential.

Program Background

MercyFirst is a member of the Collaborative for Children and Families Health Home serving youths 0–20 years of age. Core values guiding our Health Home and Care Management work include:

• Services must be family-driven and youth-guided, based on each child’s and family’s strengths and needs.
• Care must be individualized to meet each member’s established goals, outcomes, and needs.
• Supports should be community-based, with service delivery and system management rooted in a supportive, adaptive community infrastructure.
• Service models should follow evidence-based practices and be trauma-informed.

Position Summary

The Care Manager is responsible for the overall provision and coordination of services for an assigned caseload. The role guides enrollees and their caretakers through the health care system by addressing access issues, building relationships with providers, and tracking interventions and outcomes. The Care Manager serves as the central point of contact for families and the key link among providers to ensure alignment and consistent information.

Required Qualifications

• Bachelor’s in social work or Associate’s in a related field
• Bilingual Spanish proficiency
• Two years of related experience serving children and families in child welfare, developmental disabilities, mental health, healthcare, and/or preventive services
• Experience providing service coordination, including information, linkages, and referrals to community-based services
• Excellent verbal and written communication skills
• Proficiency in Microsoft Word and Outlook
• Ability to engage effectively with clients
• Commitment to MercyFirst’s mission, core values, Sanctuary Commitments, and social justice

Responsibilities

• Obtain required Care Management enrollment consents from the individual or legal guardian
• Complete initial and ongoing needs assessments (Child and Adolescent Needs and Strengths; CANS) to determine the appropriate level of care management
• Responsible for the overall management of the patient’s Individualized Plan of Care
• Develop a patient-centered Individual Plan of Care and complete assessments
• Support adherence to treatment recommendations
• Monitor and evaluate a patient’s needs across prevention, wellness, medical, mental health, care transitions, and social/community services
• Meet client contact requirements; for children, maintain in-person visits on a consistent schedule aligned to acuity level (high, medium, or low)
• Meet Care Management documentation requirements using the designated Care Management Portal (MAPP) and Electronic Health Records
• Function as an advocate for clients within the agency and with external providers
• Promote wellness and prevention by linking enrollees with resources and services aligned to their needs and preferences
• Educate children/caregivers on chronic-condition care, immunizations, screening, and other preventive interventions
• Help clients obtain and maintain public benefits necessary for health care access, including Medicaid, cash assistance, Social Security, SNAP, housing, legal services, employment and training supports, and others
• Communicate and share information with individuals, families, and caregivers with attention to language, literacy, and cultural preferences
• Conduct care planning meetings/conferences and serve as an interdisciplinary team member to provide comprehensive, holistic care
• Identify community-based resources and actively manage referrals, access, engagement, follow-up, and service coordination
• In the event of hospital admissions, engage in discharge planning to ensure recommended post-discharge services are in place before discharge
• Attend ongoing staff development trainings to enhance skills for the Care Manager role
• Ensure periodic evaluations and follow-up treatment for dental, vision, and hearing care per Medicaid EPSDT guidelines
• Perform other duties as needed by the Collaborative for Children and Families Health Home

Benefits

• Comprehensive health insurance package including medical, dental, and vision for you and your family
• 403(b) retirement benefits
• Employer-paid life insurance and long-term disability insurance
• Generous paid time off (vacation, personal, sick, 12 paid holidays)
• Free employee assistance program through National EAP
• Insurance discounts for staff and their families
• Trainings to support professional and personal development
• Employee wellness program
• Employee recognition activities

Pay

$50,000 – $56,000 per year, depending on credentials.