CARE DELIVERY MANAGER

JOB PURPOSE:

Responsible for supporting the nursing standards of excellence with advance professional education to deliver high-quality care. Serve the organization as a member of the management team, working alongside with all departments and employees to support and oversee the day-to-day operations. Provide guidance, and deliver best practices in achieving organization’s objectives, goals, and mission. Cultivate an environment dedicated to improving experience, enhancing satisfaction and retention. 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.

JOB RESPONSIBILITIES:

• Review and ensure effective development and execution of personalized care plans that result in improved satisfaction & outcomes for all participants.

• Facilitate and complete the process of Interdisciplinary Team (IDT) meetings, Service Delivery Requests (SDR) and other meetings. This includes completing the attestations, as needed. Support and collaborate with the Virtual IDT as needed.

• Serve as a manager on call during non-operational hours of the physical sites and responsible for follow ups including follow up documentation and initiating grievances on participants/caregivers’ behalf in timely manner.

• Responsible for running necessary Clinical Delivery reports.

• Participates and represents the Community Health Nurse (CHN) in all IDT meetings, when required.

• Balance and allocate staffing and related resources throughout the site and ensure adequate team assignments and coverage as a seamless operation.

• Responsible for ongoing communication with IDT and necessary parties involved to coordinate care consistent with the participants’ health care needs and goals to support in attaining and maintaining optimal health status.

• Collaborate with clinicians to review UAS and the UAS analyzer system to ensure accuracy of their assessments.

• Ensure all incidents are investigated and addressed accordingly. Ensure Level 2 investigation and documentation are completed in a timely manner according to the CLHC regulation.

• Ensure documentation for participants are complete, accurate, including and not limited to enrollment, disenrollment, electronic/paper medical record, and any other clinical notes.

• Review participants’ charts for quality and address any deficiencies.

• In collaboration with the Transitions in Care Team, provide care management services across sites and communicate with appropriate team members, facility, discharge planner, and home care coordinator when members are transitioned between care settings.

• Coordinates, facilitates, and arranges for long-term care services in nursing homes, rehab facilities, etc. as needed.

• Monitor 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 goals.

• Ensure documentations are in accordance with CLHC standards and federal/state regulations.

• Maintain up-to-date knowledge about current health-related issues, procedures, evidence-based clinical practices guidelines, medications, and impacting health and practice standards.

• Recommend and contribute to improvements in services, programs, policies, and procedures to ensure optimum care and services to members.

• Collaborate with Human Resources Department (HR) in conducting Interviews, coaching and disciplinary action if needed. Assist in onboarding and professional development training of staff to ensure compliance with policies/procedures/regulations as well as developing a continuous learning environment focused on growth and continued advancement. Ensures appropriate regulatory compliance is effective and being met at all federal and state levels.

• Evaluates the work performance and competency of direct reports. This includes ongoing informal feedback/counseling/support and completion of annual performance reviews.

• Ensures that direct reports conduct their duties according to applicable rules and regulations as well as the organization’s policies and procedures.

• Investigate and resolve employee grievances and complaints.

• Serve as the Director of Patient Services (DPS) for the LHCSA, as assigned.

• Only act within the scope of the individual’s authority to practice.

• Meet a standardized set of competencies for the specific position description established by the PACE organization before working independently.

• Acting member of the IDT.

• All other duties as assigned.

Schedule: 8:30AM – 5:00PM

Weekly Hours: 37.5

QUALIFICATIONS:

Education:

• Degree from an NLN accredited nursing school (RN, BSN required or at least five (5+) years’ experience in health care setting).

• Successful completion of an accredited Nursing Program is required.

• A Baccalaureate degree is highly desired.

• Completed NYSED-approved infection control coursework.

• A minimum of 8.0 education contact hours may include contact hours of mandatory training requirements such as infection control coursework.

• Case Management Certification recommended within two (2) years of the employment.

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 is required.

• Managed long-term care insurance experience beneficial.

• 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.

• Supervisory experience is required.

License: Current active and unrestricted license and registration in New York State as a Registered Nurse required.

Additional Requirements:

• 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.

Language: Bilingual preferred.

Physical Requirements

Individuals must be able to sustain certain physical requirements essential to the job. This includes, but is not limited to:

• Standing – Duration of up to 6 hours a day.

• Sitting/Stationary positions – Sedentary position in duration of up to 6-8 hours a day for consecutive hours/periods.

• Lifting/Push/Pull – Up to 50 pounds of equipment, baggage, supplies, and ability to lift patients safely and using OSHA guidelines, etc.

• Bending/Squatting – Must be able to safely bend or squat to care for patients, use medical supplies, etc.

• Stairs/Steps/Walking/Climbing – Must be able to safely maneuver stairs, climb up/down, and walk to access work areas Position requires the individual to be able to travel, and walk between sites/locations and work areas throughout the day.

• Agility/Fine Motor Skills – Must demonstrate agility and fine motor skills to operate and activate equipment, devices, instruments, and tools (ie. typing, use of medical supplies, equipment, etc.)

• Sight/Visual Requirements – Must be able to visually assess patients, read orders type/write documentation, etc. with accuracy.

• Audio Hearing and Motor Skills (language) Requirements – Must be able to listen attentively and document information from patients, community members, providers, etc., and intake information through audio processing with accuracy. In addition, must be able to speak comfortably and clearly with language motor skills for customers to understand the individual.

• Cognitive Ability – Must be able to demonstrate good decision-making, reasonableness, cognitive ability, rational processing, and analysis to satisfy essential functions of the job.

Disclaimer: Responsibilities and tasks outlined in this job description are not exhaustive and may change as determined by the needs of the company.

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.

Salary Range (Min-Max):$120,000.00 – $125,000.00