Senior UAS Case Manager

Brooklyn NY 11201

This is a traveling position. Candidate has to travel Brooklyn, Queens, The Bronx, Manhattan, and West Chester.

The hiring manager is looking for Bi-lingual candidates!!! English Spanish, English Bengali, English Russian, and or English Mandarin.

Responsible for the completion of

· 1) UAS Initial Assessments and Reassessments based on NY State requirements and guidelines and training provided outside resources.

· 2) Enrollment paperwork materials required to appropriately process consumer’s application for enrollment.

· 3) UAS Tasking Tool based on guidelines and training provider by and/or outside resources. Responsible for correction and revision of UAS, paperwork, and tasking tool documentation based on review and feedback provided through quality and associated review processes.

· Complete UAS Initial and/or Reassessment documentation, enrollment paperwork, and tasking tool in the consumer’s home.

· Attend training and continuing education sessions and lessons focused on the proper completion of UAS documentation, enrollment paperwork, and tasking tool.

· Focus on continuous improvement and quality excellence in the completion of all material associated with the initial enrollment/continued enrollment of consumers as members in the plan.

· Supports initiatives of the Quality Assessment and Performance Improvement Committee.

· All other duties as assigned.

Education Level: Bachelor's Degree

Requirements/Certifications:

· UAS Assessor experience is a MUST!!!

· Minimum 5 years clinical experience with focus in managed care, including behavioral health disease or case management.

· Care Mgmt.\RN - Registered Nurse, State and/or Compact State Licensure

· Understands and is able to apply principals of Care Management and Person Centered Service Planning.

· Is able to apply Milliman Care Guidelines and other applicable, evidenced-based clinical guidelines.

· Is able to understand and apply coverage guidelines and benefit limitations.

· Familiar with clinical needs and disease processes for chronic physical and behavioral illnesses (depression, challenging behaviors, Alzheimer’s disease and other disease-related dementias).

· Understands and adapts appropriately to issues related to communication, cognitive or other barriers.

Riya Khem

Clinical Recruiter

Integrated Resources, Inc.

IT Life Sciences Allied Healthcare CRO

Certified MBE |GSA - Schedule 66 I GSA - Schedule 621I

DIRECT # - 732 662 4717| (W) # 732-549-2030 - Ext - 311 |(F) 732-549-5549