Accountable Care Manager - Case Management (Part-Time - 23 Hours per Week) Weekends
Job description
About NYC Health + Hospitals
Since 1875, South Brooklyn Health has established its reputation for clinical excellence and culturally competent care. It has designations as a Certified Percutaneous Coronary Intervention (PCI) Center, an Advanced Primary Stroke Center, an accredited Baby-Friendly Hospital, a U.S. News & World Report high performing hospital. The hospital's staff is as diverse as the patients they serve. Interpreter services can be provided at any time of the day or night in over 130 languages.
At NYC Health + Hospitals, our mission is to deliver high quality care health services, without exception. Every employee takes a person-centered approach that exemplifies the ICARE values (Integrity, Compassion, Accountability, Respect, and Excellence) through empathic communication and partnerships between all persons.
Job Description
Shift: Day Flex (8:00 A.M. – 8:30 P.M.) Weekends
Purpose:
To facilitate and coordinate the care delivered to an assigned group of patients. This is accomplished through managing, coordinating, facilitating and monitoring resources to achieve optimal clinical outcomes, utilization service, and financial goals and discharge planning. Promote strategies and forums for collaboration and mutual problem solving. Recommends alternatives to in-patient care and assist the physician with patient through-put issues to address unnecessary days which increase the length of stay and have negative financial ramifications.
Specific Duties and Responsibilities:
- Facilitates Care
- Foster a collaborative relationship with the clinical staff to facilitate Case Management objectives to reduce LOS, ensure appropriate admissions, and increase patient satisfaction, monitors acuity to assure reimbursement.
- Conduct accurate assessment of assigned patients, determining clinical and social status using established criteria.
- Conduct a thorough chart review and prepares and submits clinical reviews to the MCO’s electronically through EPIC, Allscripts Care Management (ACM), UM Database or telephonically.
- Identify discharge needs upon admission, request Social Work Service and other appropriate referrals within one working day of conducting an admission review.
- If appropriate, negotiate with physician(s) and other health care professionals to reach a more effective and alternative plan to in-patient care; review consults, duplication of tests, deviations from care guidelines, delays in diagnostic treatment and/or scheduling.
- Consult and collaborate with physicians and other health care professionals to assure accurate and timely documentation of patient progress towards positive clinical outcomes.
- Takes appropriate action to resolve operational bottlenecks which affect patient flow.
- Refer potential quality concerns to Risk Management Department and/or Infection Control Department as appropriate.
- Identifies and facilitates resolution of "roadblocks" collects data in support of the utilization management process.
- Through a multidisciplinary approach, assure that the next level of care is appropriate and that the services are in place prior to discharge. Appropriate updated documentation of discharge plans as needed.
- Will attend and report variances at multidisciplinary rounds on his or her unit on a regular basis.
- Will collaborate with nurse clinicians on a daily basis.
- Interface with managed care companies and other insurance carriers to facilitate timely payment and respond to insurance denials.
- Facilitate the Peer to Peer Process to positively affect the revenue cycle.
- Maintains current knowledge of The Joint Commission, New York State Department of Health, IPRO, Livanta, Medicare and Medicaid Standards.
- Acquire proficiency of computer use to facilitate medical management especially as it relates to EPIC/ACM.
- Performs other related duties as required by director or supervisor.
Minimum Qualifications
1. Valid New York State license and current registration to practice as a Registered Professional Nurse issued by the New York State Education Department (NYSED); and
2. A Baccalaureate degree in Nursing or related health field from an accredited college or university; and
3. Two (2) years of experience as a Registered Professional Nurse.
Department Preferences
ACLS/ BCLS/PALS certified
At least 2 years’ experience on general unit
How To Apply
Please be advised that proof of Covid-19 vaccination is required prior to hire.
If you wish to apply for this position, please apply online by clicking the "Apply Now" button.
NYC Health and Hospitals offers a competitive benefits package that includes:
- Comprehensive Health Benefits for employees hired to work 20+ hrs. per week
- Retirement Savings and Pension Plans
- Loan Forgiveness Programs for eligible employees
- Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts
- College tuition discounts and professional development opportunities
- Multiple employee discounts programs
Vacancy Control Board Number
VCB #: CON-03312023-0613
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