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Hybrid Clinical Care Manager, Population Health Advanced Illness Program (Per Diem) presso Visiting Nurse Service of New York d/b/a VNS Health

Visiting Nurse Service of New York d/b/a VNS Health · New York, Stati Uniti d'America · Hybrid

$103,064.00  -  $128,876.00

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Overview:Provides telephonic clinical care management services using evidence-based practices to ensure effective utilization of benefits, services, and care is provided to the patients allowing them to remain safely in their home/community.Responsibilities:
What We Provide
  • Personal and financial wellness programs   
  • Opportunities for professional growth and career advancement   
  • Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities    
  • Referral bonus opportunities   

What You Will Do 

  • Coordinates and/or oversees the coordination of benefits and services for all members on his/her caseload.
  • Completes care management and disease specific assessments.
  • Makes timely telephonic care management calls based on risk level.
  • Resolves and coordinates complex issues and member complaints impacting the delivery of services.
  • Provides health education to member/caregiver.
  • Assess SDoH and provide care coordination to reduce/remove barriers of care to include ability to allow for changing levels of care based on assessments, trigger events and program data/reports.
  • Identifies member safety issues and intervenes as necessary or refers to appropriate resources, such as community linkages, dietary, therapy (PT/OT/ST), HHA services, behavioral health, and DME.
  • Coordinates the delivery of high quality, cost-effective care based on a customized population model of care supported by evidence based clinical practice guidelines.
  • Advocates for the member/caregiver to obtain the health care and other services needed to optimize their quality of life.
  • Utilizes the Care Management process to set priorities, plan, organize and implement interventions that are goal directed towards self-care outcomes and the transition to independent status.
  • Promotes adherence to the physician treatment plan by providing education, coaching and support.
  • Educates, coordinates, and provides resources to reduce inappropriate utilization of emergency room (ER) and hospital service.
  • Increases utilization of primary care, specialty care, preventive health and guideline-based treatments including proper pharmacotherapy within network, as appropriate.
  • Participates in interdisciplinary team (IDT) meetings and provide input on customer service-related activities.
  • Protects the confidentiality of member information and adheres to company policies regarding confidentiality.
  • Ensures compliance with payors’ policies and procedures as well as all Federal and State regulations.
  • Interprets and implements VNS Health policies, state and federal regulations.
  • Participates in special projects and performs other duties as assigned.
Qualifications:

Licenses and Certifications:

  • License and current registration to practice as a Registered Professional Nurse in NYS required or
  • New York State License and current registration in Physical Therapy required or
  • New York State License and current registration in Occupational Therapy required
  • Certified Case Manager - Commission for Case Manager Certification within 1 year of employment required


Education:

  • Associate's Degree in nursing required or
  • Bachelor's Degree in Physical Therapy from a program approved by the New York State Department of Education required
  • Bachelor's Degree in nursing preferred


Work Experience:

  • Minimum two years of experience in health related field required
  • Care management and/or managed care experience preferred
  • Proficiency in Microsoft Office applications required
  • Demonstrated analytical skills required
Pay Range:USD $49.55 - USD $61.96 /Hr.
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