Care Management Analyst CMO

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Working under the supervision of a licensed/certified clinical professional, the Care Management Analyst (CMA) is responsible for managing operational processes for the Comprehensive Kidney Care Contracting (CKCC) program. The CMA is responsible for onboarding and consenting patients for the program. The CMA collects and organizes information from multiple sources including members, caregivers, physicians, clinical information systems and electronic health records. The CMA uses this information to make decisions regarding the appropriateness of utilization and benefit application for specific health care services and/or directs this information to appropriate staff for intervention/follow-up in accordance with established organizational and/or departmental protocols, policies and procedures. The CMA may assume responsibility for managing the above activities for a case load of members or may manage specific processes and tasks related to case management activities. The CMA interfaces with and acts as a resource to CKCC team members, other MMC and CMO departments, members/caregivers and physicians/care providers. This position will require in-person work with patients and travel to different sites of care.

Key responsibilities in the CKCC program include:

• Ensure that patients are aware of their enrollment in the program, obtain consent forms, provider verification

• Ensure that Rx fills, appointment scheduling, F/u appt with provider,  finding transportation for patients are secured

• Facilitate completion of Patient Activation Measure forms

• Support completion of post-discharge calls and scheduling of post-discharge visits

• Facilitate referrals to dialysis facilities for new outpatient dialysis starts

Requirements:

• Associates degree required. Bachelor’s Degree preferred.

• Required Licensure in a health or human services discipline (e.g. LPN, LMSW, LCSW,  Registered Dietitian, etc.). 

• Current active license/registration in New York State.

• Medical Management experience in a managed health care setting preferred.

• Appropriate training and experience in case management preferred.