Care Manager, HARP

Key Responsibilities:

• Complete the HCBS Eligibility Assessment for HARP/SNP members in the Uniform Assessment System-New York (UAS-NY) within 60 days of enrollment.

• Ensure all assessments are conducted in compliance with HARP/SNP guidelines, including in-person or telephonic assessments

• Work with the Care Manager (CM) to ensure they understand the assessment results and the member’s HCBS goals.

• Ensure that all HARP-related goals and tasks are included in the member’s Plan of Care (POC)

• Document the member’s decision regarding HCBS/CORE services in FCM encounter notes, HCBS-CORE tab, and POC.

• Update the POC as necessary based on the HCBS or CORE services the member receives, including service frequency, scope, and duration.

• Manage member referrals for HCBS or CORE services, ensure an accurate and timely referral process, documenting the referral
• Coordinate with HCBS providers and MCOs, ensuring the members are offered a choice of providers, and follow up on the referral process to remove any barriers to care.

• Monitor ongoing services and assist members in accessing the full range of HCBS/CORE services they are eligible for.

• Educate members about their HARP/SNP plan and available HCBS/CORE services within 30 days of enrollment.

• Engage members to determine their interest in and eligibility for HCBS/CORE services, providing support throughout the referral and service initiation process.

• Document any changes in member interest regarding HCBS/CORE services, ensuring all updates are reflected in FCM and the Plan of Care.

• Complete annual HCBS Eligibility Assessments for members already receiving HCBS services.

• Ensure the updated eligibility report is uploaded to the HCBS-CORE tab in FCM.

• Coordinate with the MCO to review and approve any necessary changes to the Plan of Care.

Qualifications:

• A Master’s degree in one of the qualifying fields and one (1) year of Experience ; OR

• A Bachelor’s degree in one of the qualifying fields and two (2) years of Experience; OR

• A Credentialed Alcoholism and Substance Abuse Counselor (CASAC) and two (2) years of Experience; OR

• A Bachelor’s degree or higher in ANY field with either: three (3) years of Experience, or two (2) years of experience as a Health Home care manager serving the SMI or SED population

• Clinical Assessment Skills

• Ability to conduct structured assessments using the UAS-NY and interpret findings to determine HCBS/CORE eligibility.

• Familiarity with HARP/SNP, HCBS, CORE, and Medicaid behavioral health services.

• Experience in collaborating with care teams, providers, and managed care organizations (MCOs) to ensure timely and appropriate service delivery

• Ability to engage with members to assess interest, explain services, and support service initiation in a trauma-informed and culturally competent manner

• Excellent verbal and written communication skills for interfacing with members, care managers, MCOs, and service providers

• Ability to troubleshoot and resolve service access barriers and coordinate care transitions.

• Comfortable using electronic health records, care coordination systems (e.g., FCM), and telehealth tools for remote assessments.

• Bilingual in English and Spanish preferred.