CARE MANAGER - NURSING

CenterLight Health System • New York, NY

6d • $98,000 - $108,000 • Remote

About The Position

Responsible for overall care management and quality of care for participants. Uses specialized discipline-specific knowledge to review assessments of field staff and coordinate a holistic care plan that addresses all domains of care. Provides care coordination in a manner that is sensitive to age, gender, sexual orientation, cultural, linguistic, racial, ethnic, religious backgrounds, and congenital or acquired disabilities.

Requirements

• Graduated from a Nursing education program acceptable to New York State Education Department (NYSED).
• Minimum of two (2) years of Care Planning Experience.
• Minimum of two (2) years of administrative experience in a management capacity in a certified home health agency (CHHA), long-term home health care (LHCSA), acute care, medical-surgical, and/or critical care, nursing home experience, diagnostic & treatment clinic preferred.
• Customer Service experience required.
• Minimum of one (1) year of experience working with a frail or elderly population or, if the individual has less than one (1) year of experience but meets all other requirements, must receive appropriate training from the PACE organization on working with a frail or elderly population upon hiring.
• Current active and unrestricted license and registration in New York State required.
• Be legally authorized (for example, currently licensed, registered, or certified if applicable) to practice in the State in which the healthcare professional will perform the function.
• Be medically cleared for communicable diseases and have all immunizations up-to-date before engaging in direct participant contact.

Nice To Haves

• Bachelor's degree preferred.
• Managed long-term care insurance experience beneficial.
• Supervisory experience preferred.
• Bilingual preferred.

Responsibilities

• Participates and represents their discipline in the care planning meetings or as necessary.
• Reviews all discipline-specific documentation for quality and addresses any deficiencies with the field staff following disciplinary steps established by the Discipline Policy.
• Monitors how field staff is documenting all interventions with the participants and address/document any issue observed with the employee.
• Conducts coaching sessions with field staff as needed.
• Communicates with the discipline-specific field staff regularly to coordinate a continuum of care consistent with the Member’s health care needs and goals. This care plan supports the Member in attaining and maintaining an optimal functional and health status.
• In coordination with the IDT, arranges, coordinates, and authorizes the provisions of appropriate services to meet identified member-specific needs (such as assistance with the Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs), housing, home-delivered meals, and transportation) and when approved by the IDT, may authorize a range and number of community-based services.
• Implements specific care management activities and interventions that lead to accomplishing the participant’s goals.
• Provides care management services across sites and collaborates with appropriate team members, facility, discharge planner, and home care coordinator when members are transitioned between care settings.
• Documents services in accordance with CLHC standards and federal/state regulations.
• Coordinates, facilitates, and arranges for long-term care services in nursing homes, rehab facilities, etc. as needed.
• Collaborates with PCP and other Specialty physicians and specialty-based services and members of IDT regarding any changes in participant’s condition to secure, arrange and coordinate all resources for implementing optimal care.
• Provides or arranges for ongoing Skilled services, service authorization, and periodic assessment reassessment and evaluation of services.
• Monitors care management activities, services, and members’ responses to interventions, to determine the effectiveness of the plan of care and the utilization of services and implements changes and adjustments to meet needs and resolve goals.
• Evaluates the effectiveness of the plan of care in reaching desired goals and outcomes, makes modifications or changes in the plan of care based on changes in the member’s health, as needed.
• Fiscally responsible for providing services based on members’ needs.
• Maintains up-to-date knowledge about current health-related issues, procedures, evidence-based clinical practice guidelines, medications, and impacting health and practice standards.
• Conducts competencies, and training sessions with field staff as needed.
• Recommends and contributes to improvements in services, programs, policies, and procedures to ensure optimum care and services to members.
• Follows the organization’s policies regarding disciplinary action. Engages Human Resources as needed for guidance on disciplinary actions and terminations.
• Acts only within the scope of the individual’s authority to practice.
• Meets a standardized set of competencies for the specific position description established by the PACE organization before working independently.
• Acts as a member of the IDT.
• Performs all other duties as assigned.

Benefits

• We are an affirmative action and equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, height, weight, or genetic information.
• We are committed to providing access, equal opportunity, and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level