PC Support Manager jobs in Hempstead, NY

Heritage New York Medical is a medical practice which includes an interdisciplinary regional team of MDs, Nurse Practitioners, Clinical Pharmacists, Licensed Clinical Social Workers, and highly skilled support staff to bring the best care to patients. At HNYMPC patient health and overall well-being is our undivided focus. We serve patients in all 5 boroughs, Nassau, and Suffolk Counties. We use innovative technology to deliver a cutting-edge healthcare experience and to make a difference in the communities we serve.

HNYMPC is seeking skilled and compassionate Registered Nurse (RN) to join our healthcare team in the Population Health Nurse Care Manager position. Excellent growth opportunity with the addition of new health plans. This is a hybrid position at our Garden City location. The person in this position will be responsible for providing high-quality patient care and supporting our physicians in the delivery of medical services. The successful candidate will have a strong understanding of medical terminology, be able to work effectively in a fast-paced environment, have excellent communication and interpersonal skills, and be willing and able to provide intensive care management services to members who have one or more risk factors to prevent progression of disease and improve quality of life.

While in the office, responsibilities include leading daily inpatient rounds, coordinating preventative screening tests to include but not limited to coordination of quality patient focused care for a select group of patients with escalating chronic conditions, which include Diabetes, heart failure and hypertension. To monitor care, identify variances, and facilitate progress towards expected outcomes across the continuum of patient care. Incorporate CMS STAR quality measures such as A1C control, facilitating lab draws, Diabetic Retinal Exams (DRE) and Bone Density Screening in the home setting to be interpreted by our Physicians.

ESSENTIAL JOB FUNCTIONS:

· Collaborate with all specialties and lead daily clinical inpatient rounds and facilitate discharge planning to avoid a readmission.

· Interact and work closely with interdisciplinary team to manage select population health patients with the potential for a hospitalization.

· Participation in multidisciplinary clinical rounds as appropriate.

· Identify and manage transition of care issues as appropriate.

· Utilize internal and external resources and systems to effectively meet patient and family needs.

· Develop and implement individualized clinical plans of care which consider diagnosis, assessment data, physician collaboration and treatment plan.

· Monitor care delivery using Clinical Care protocols.

· Utilize internal and external resources and systems to effectively meet patient and family needs.

· Assess and identify variances from the established plan of care and coordinate preventative care services such as colonoscopies, mammograms etc.

· Use effective communication strategies with patients, families, physicians, all staff members, and community agencies.

· Identify issues appropriate for physician collaboration and/or interdisciplinary consultations to develop, implement and monitor plan of care.

· Utilize relevant research findings to guide and select options for management.

· Present clinical cases to the Interdisciplinary Care Team to reduce admissions and re-admissions.

· Assess and identify variances from plan of care.

· Maintain and interpret statistical information on care management activity outcomes (i.e., A1C variance and trends)

· Implement processes to ensure achievement of targeted service levels, profitability, productivity, and customer satisfaction.

Qualifications

• NY State Licensed RN with bachelor’s degree in nursing preferred.
• Certification in Case Management preferred.
• 2 years Insurance / MSO Care/Case Management / High Intensity preferred.
• 4 years Home Health Case management experience a plus.
• Must be well organized and be able to multi-task.
• Proficiency with basic software programs. Training to be provided. Must be readily adaptable when trained.

EXPERIENCE: SKILLS, KNOWLEDGE & ABILITIES:

• Excellent written and oral communication skills.
• Experience working with high risk / geriatric population preferred.
• Independent problem identification/resolution and critical decision-making skills.
• Must be able to prioritize, plan, and handle multiple tasks/demands simultaneously.
• Interdisciplinary team player, detail oriented and flexible.
• Knowledge of Managed Medicare / Medicaid reimbursement guidelines for home health.
• Proficient with Microsoft Office applications, Word, and Excel.
• Knowledge of Clinical Based Guidelines, which include but not limited to Milliman, UpToDate and InterQual.
• Knowledgeable with NCQA and URAC standards a plus.

Job Type: Full-time

Pay: $85,000.00 - $100,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible spending account
• Free parking
• Health insurance
• Life insurance
• Mileage reimbursement
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift

Work setting:

• Hybrid work
• Telehealth

Experience:

• Managed care: 2 years (Preferred)
• Care Management: 2 years (Required)

License/Certification:

• NY State RN license (Required)

Ability to Relocate:

• Garden City, NY 11530: Relocate before starting work (Required)

Work Location: Hybrid remote in Garden City, NY 11530