Health & Wellness Advisor II Job Ref:36913 Category:Professional Department:PARTNERSHIP IN CARE Location:Brooklyn, NY Job Type:Regular Employment Type:Full-Time Hire In Rate:$75,000.00 Salary Range:$75,000.00 - $75,000.00 This is a field position, so while you may have a preference for a specific area, please note that you may be deployed to a different area, based on the organization's needs. Marketing Statement MetroPlus Health Plan provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlus network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlus has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life. Position Overview Under the direction of the Health & Wellness Advisement Team Leader, the Health & Wellness Advisor (Level 2) ensures the promotion of health and wellness of HIV+/AIDS and other SNP members with medium and high level acuity through the oversight and development of a Plan of Care that encompasses the assessment of health and psychosocial needs, ongoing retention and engagement in care, high level adherence to antiretroviral therapy, health education and coaching on HIV disease, HIV primary and secondary risk reduction, and other co-morbid illnesses, and referral to community resources and services when appropriate. In the instance of co-management with behavioral health services, the Health & Wellness Advisor (Level 2) ensures all of the above except co-morbid mental health and substance abuse needs and services. Job Description -Orients the assigned new member and reorients existing members to MetroPlus Health Plan and the scope of services the plan provides as needed. -Ensures, formulates and validates an individualized Plan of Care utilizing various databases and collateral resources such as the member, care giver, primary care provider, and/or community level case manager to identify the needs and barriers of members living with HIV in order to promote the health and wellness of the member. -Ensures that the Plan of Care identifies appropriate goals and interventions. -Promotes access to and oversees the coordination and delivery of comprehensive, quality healthcare services for HIV+ and homeless members. -Performs telephonic case management activities where needed, including care coordination, planning for transition of care, out-patient follow-up and ancillary service review throughout the continuum of care to ensure optimum health outcomes. -Provides health education on HIV disease, HIV primary and secondary risk reduction and other co-morbid illnesses, such as hepatitis C, diabetes and hypertension as indicated by the Plan of Care. -Communicates with the members primary care provider, community case manager and all other applicable providers, vendors or agencies to facilitate the health and wellness of the member in a coordinated and comprehensive manner. -Identifies service utilization trends and potential member needs by means of reviewing encounter data, pharmacy/prescription data, and the review of member health assessment tools. -Documents in a comprehensive manner to ensure that all goals, interventions and care coordination activities for each member in the DCMS system and other applicable software programs are in compliance with professional standards and regulatory guidelines. -Mentors and supports the work of HIV Services Health & Wellness Advisors (Level 1) on their assigned team and other teams when requested and participates in the competency development of HIV Services Health & Wellness Advisors (Level 1). -Ensures each assigned new SNP member has a completed Plan of Care within 30 days of enrollment and a reassessment of the Plan of Care every 180 days. -Attends and prepares for bi-weekly Interdisciplinary Care Team (ICT) meetings which will present newly enrolled, frequently admitted, and inpatient transition of care cases. To review, identify and assess the members Plan of Care and recommend changes in order to promote the health and wellness of the member. -Serves as the principal contact/representative of Partnership In Care program for the member. -Assists all MetroPlus departments with resolution of related member retention, utilization management, quality management, customer service, and provider relations concerns. -Attends approved in-service and external education and training as per department directives. -Performs other appropriate duties and participates in other special projects as assigned, including, but not limited to, audit review and preparation, quality improvement, community health education, facility/provider relations and marketing activities. -Ensures that coordination of membership enrolled in all lines of business is compliant with Federal, State, and City regulations, and are consistent with the Mission, Vision and Values of the organization. Minimum Qualifications -Bachelors degree from an accredited college or university in a healthcare-related field is required. Masters degree from an accredited college or university in Nursing, Social Work or other healthcare related discipline is preferred. -A minimum of two years of clinical experience in HIV care or support systems that includes experience in care coordination, health education and case management. A minimum of two years of experience in managed care is preferred. -Excellent interpersonal, organizational communication and analytical skills. -Computer literacy with proficiency with Microsoft Office products is required. -Bilingual (English/Spanish) is preferred. Fluency in other languages is welcomed. Licensure and/or Certification Required -New York State licensed social worker LMSW or LCSW Professional Competencies -Integrity and Trust -Customer Focus -Functional/Technical Skills -Written/Oral Communications How To Apply If you wish to apply for this position, please apply online by clicking the "Apply Now" button or forward your resume, noting the above Job ID #, to: MetroPlus Health Plan Human Resources Department 160 Water Street 8th Floor New York, NY 10038 Attn: Recruitment Unit This is position is classified as a managerial title, in addition to a variety options for Health Benefits through MetroPlus, managerial employees receive vision, dental, gym reimbursement and life insurance benefits through the Management Benefits fund of the City of New York. Please view the benefits page for more detailed information.