Accountable Care Manager

Job TitleApply for JobAbout NYC Health + HospitalsLincoln Medical and Mental Health Center is one of New York City's premier acute care hospitals. Located in Downtown Bronx, Lincoln is a teaching hospital renowned for its Centers of Excellence, and a recognized industry leader in the implementation of state-of-the art medical technology and best practices. Our team of highly trained and caring medical professionals is dedicated to providing the highest quality health care that is safe, compassionate, culturally competent and patient-centered. Comprehensive services are offered in three major primary care areas: Medicine, Pediatrics, and Women's Health in addition to more than eighty (80) specialty services. At Lincoln, the safety and comfort of our patients is our number one priority. 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.Work Shifts9:00 A.M – 5:30 P.M; Rotating Weekends & Holidays. *[37.5 Hours per Week.]Duties & ResponsibilitiesPurpose of Position : Under general supervision, with varying degrees of latitude for independent initiative and judgment, coordinates and monitors the management of patient-centered quality care, ensuring optimal utilization of resources, service delivery, and compliance with external review requirements and applicable state and federal rules and regulations and nursing standards of care for better outcomes and improved patient experience. Facilitates patient's progress from admission through discharge, and promotes strategies and forums for collaboration and mutual problem solving. Examples of Typical Tasks : 1. Reviews each patient's chart. Ensures that documentation in the medical record supports plan of care and justifies admission and continued stay. 2. Coordinates and/or participates in multidisciplinary rounds; reviews plan of care; and discusses estimated length of stay, need for continued hospitalization and appropriateness of resources utilization, consultations, treatment plan and discharge plan. Completes Patient Review Instrument (PRI). 3. Collaborates and consults with physicians and other health care professionals to reach an efficient pathway of care taking and to identify, eliminate, and implement solutions to barriers, and collects and analyzes related data, as needed. 4. Communicates with Health care setting investigation/reimbursement department and third-party payers to obtain authorizations and ensure appropriate reimbursement, and provides clinical reviews and updates to managed care companies, as needed. 5. Plans and implements strategies to reduce length of stay, reduce resource consumption, and achieve positive client/patient outcomes. May coordinate the implementation of health care setting initiatives designed to increase revenue. Maintains all related records and documentation. 6. Initiates discharge planning by assessing client/patient and family needs, including but not limited to identifying non-medical psychosocial needs and post discharge medical needs. Informs patient and family of discharge planning options based on diagnosis, prognoses, resources and preferences related to home care services. 7. Coordinates and facilitates timely implementation of discharge plans for patient; assures timely completion of discharge, transfer and referral forms, prescriptions, and discharge orders; arranges follow-up care, as appropriate. 8. Performs or coordinates the post Emergency Department discharge phone call to patient and health care providers to facilitate/coordinate and verify that successful linkage to care occurred. 9. Maintains effective communication with physicians, nursing staff, clients/patients, families and others related to discharge planning; coordinates with social services personnel to provide needed services. 10. Contacts and directly engages patient's primary care physician and/or health care providers to support continuity of care and effective care transition. 11. May interview, orient, train, mentor and coach new care management staff, and coordinate and supervise the performance of care coordinators and social work staff performing discharge planning and assessment. 12. May collaborate in the development of departmental policies and procedures, clinical practice guidelines and critical pathways for designated targeted diagnosis. 13. May act as an educational resource and provide consultation regarding case management, discharge planning process, clinical documentation requirements and applicable federal, state and local regulations; may identify benefits, implications, and limitations of home care.Minimum Qualifications1. 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. Holds, or obtains through facility orientation, a valid and current certification in Basic Life Support (BLS) through the American Heart Association (AHA); and 4. Two (2) years of experience as a Registered Professional Nurse.Additional Salary CompensationIn addition to base compensation, you may also receive the following based on the Collectively-Bargained Agreement: An annual education differential if you currently possess an appropriate degree in nursing or an allied health discipline from an accredited college or university, as listed below: Bachelors of Science in Nursing (BSN) = $900 Masters in allied health discipline = $1,200 Masters of Science in Nursing (MSN) = $2,000 Doctorate in Education, Nursing Practice or PhD in Nursing (DNP) = $2,500 An annual certification differential of $2,000 if you currently hold a Case Management certification that is nationally recognized in the discipline or area of specialization for which you are employed. An annual nursing experience differential ranging from $1,097 up to $9,100 for up to 10 years of experience if you have outside nursing experience as an Accountable Care Manager.BenefitsNYC 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 Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts Loan Forgiveness Programs for eligible employees College tuition discounts and professional development opportunities College Savings Program Union Benefits for eligible titles Multiple employee discounts programs Commuter Benefits ProgramsHow To ApplyIf you wish to apply for this position, please apply online.