MetroPlusHealth 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, MetroPlusHealth network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlusHealth has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.
The Care Manager (CM) is responsible for reviewing, and approving Plans of Care, CANS-NY assessments and HCBS services. The CM is also responsible for the authorization of inpatient and DME requested by Medically Fragile and Care at Home children according to UM requirement set forth by the “office of Health Insurance Programs Principles for Medically Fragile Children. The CM works with Health Home Coordinators and LDSS/VCFA to ensure proper access, level of care, level of need and continuation of care for Medically Fragile and Care at Home children.