Care Manager, Children & Families

Care Collab is launching a Children's Care Management Agency (CMA) under New York State's Medicaid Health Home program in partnership with the Collaborative for Children and Families (CCF) Health Home. The program serves children and adolescents with complex medical, behavioral, and developmental health needs, providing comprehensive, person-centered care coordination in home and community-based settings.

At Care Collab, we believe technology should enhance, not hinder, care delivery. We are building an innovative care management model that leverages technology and streamlined workflows to reduce administrative burden, allowing Care Managers to spend more time focused on members and families while maintaining compliance with Health Home, Medicaid, and regulatory requirements.

As a Children's Care Manager, you will play a critical role in helping children and families navigate healthcare, behavioral health, educational, and community systems to achieve improved health outcomes, greater stability, and long-term success.

The Children's Care Manager is responsible for coordinating care and services for children and adolescents enrolled in the Children's Health Home program. Using a strengths-based, family-driven, and trauma-informed approach, the Care Manager conducts assessments, develops comprehensive Plans of Care, coordinates services across multiple systems, monitors progress toward goals, and advocates for members and families.

The Care Manager serves as the primary point of contact for the child, family, providers, and community partners, ensuring services are integrated, accessible, and responsive to each member's unique needs.

This position is eligible for remote work; however, substantial field-based responsibilities require travel throughout the assigned service area to conduct member visits and coordinate services.

• Conduct comprehensive assessments to identify medical, behavioral health, educational, social, and environmental needs.
• Develop and implement individualized Plans of Care (POC) in collaboration with children, families, and multidisciplinary teams.
• Coordinate services among healthcare providers, behavioral health specialists, schools, social service agencies, and community organizations.
• Monitor service utilization, track progress toward goals, and adjust care plans based on changing needs and circumstances.
• Facilitate transitions of care, including hospital discharges, school transitions, and movement between service providers and community programs.
• Maintain progressive and regular contact with members and families through home visits, community visits, telehealth, and other approved methods of engagement.
• Meet productivity, quality, compliance, and member engagement standards established by Care Collab and the Health Home program.

• Build trusting relationships with children and families through culturally sensitive, trauma-informed, and person-centered practices.
• Educate children and families regarding available services, benefits, and treatment options.
• Empower children and families to actively participate in care planning and decision-making.
• Support child and family self-advocacy and the development of long-term support systems.
• Foster collaboration among family members, caregivers, and service providers to support successful outcomes.

• Refer and connect members to medical, behavioral health, educational, housing, transportation, and social support services.
• Facilitate communication among service providers to ensure coordinated and integrated care delivery.
• Monitor service utilization and follow-up on referrals to ensure successful engagement with recommended services.
• Identify barriers to care and work collaboratively with members, families, and providers to address unmet needs.

• Maintain accurate, timely, and complete case records in accordance with Health Home standards, agency policies, HIPAA requirements, and regulatory guidelines.
• Complete assessments, care plans, progress notes, and required reports within established timelines.
• Ensure compliance with Medicaid, Health Home, and New York State requirements.
• Utilize Care Collab's technology-enabled care management systems to document activities, manage workflows, and support quality care coordination.

• Identify risk factors and intervene appropriately during crises.
• Collaborate with emergency services, healthcare providers, family supports, and community partners when urgent needs arise.
• Advocate for children's access to quality healthcare, education, behavioral health, and community-based services.
• Support care planning and coordination efforts that promote member safety, stability, and well-being.

• Assist with quality improvement initiatives and performance measures.
• Maintain current knowledge of Health Home requirements, community resources, and…