Reimbursement Services Director - Home Care jobs in Schenectady, NY

Summary: The Regional Director is a Bachelor's prepared RN, who is responsible for planning, organizing, directing, coordinating and evaluating HCR’s patient services at the regional level, (North Country); working with clinical management to assure high quality outcomes, patient, and staff satisfaction, and attainment of revenue goals.

Essential Functions

• Participate in the development, implementation, evaluation, review, and revisions of policies and procedures consistent with current professional standards of practice.
• Develop goals, objectives, and standards of care relevant to patient services and personnel functions.

Ensure coordination of all patient services by monitoring plans of treatment, assuring case conferences are conducted, conducting periodic patient evaluations, and determining frequency and/or staffing patterns.

• Coordinate the quarterly clinical record review program.
• Ensure communication and coordination with physician’s offices, payers, patients/families, outpatient services and inpatient coordinators, regarding care and status of the patient.

Ensure decisions regarding patient referral, admission and discharge are made based on patient’s assessed needs and safety and does not jeopardize the safety of personnel.

Ensure a comprehensive interdisciplinary assessment is completed for each patient and addresses the medical, social, mental health and environmental needs of the patient.

Ensure personnel delivering patient care are adequately supervised as evidenced by:

• Compliance to patient’s plan of care
• Clinical documentation
• In-home supervision of personnel

Ensure personnel are scheduled to guarantee proper coverage within authorized staffing levels.

Responsible for recruitment of qualified personnel and implementation of effective strategies to promote staff retention at acceptable parameters established by the Agency in collaboration with the Clinical Managers and HR Department.

Ensures staff maintains up-to-date credentials, and adheres to job responsibilities and productivity requirements, by conducting timely, thorough performance reviews annually, providing more frequent feedback on low performance as needed.

Participates in the agency’s information management and performance improvement programs.

Serves as a member of the Professional Advisory Council and periodically reviews policies relevant to patient care with the council.

Participates in local organizations on activities relative to the health professions and community health services.

Responsible for the organization and directions of the ongoing functions, including, but not limited to, the following:

• Responsible for agency performance: financial, quality, regulatory.
• Managing operations within projected budget.
• Participate in the development of standards and methods of measurement of agency activity.
• Preparation of reports on agency activity for Senior Leadership Team.
• Ongoing liaison with HCR Clinical or Senior Leadership Team

Maintain a working knowledge of current Medicare, Medicaid, and third-party payor requirements for home care reimbursement.

Keep up-to-date on evidence-based care and practices, products, treatments and trends and communicate this information to personnel.

Maintain understanding and effective demonstration of nursing leadership competencies, including, but not limited to:

People:

o Build effective teams

o Manage relationships up, down and to the side

o Motivate and develop others

o Build positive work environments

Purpose:

o Respond to organizational mandates

o Project mission

o Move strategies to actions by using short-term objectives

Process:

o Manage a change process

o Manage conflict within the organization

o Use performance assessments effectively

Personal:

o Develop self-knowledge and awareness

o Use communication skills interpersonally and publicly

o Demonstrate courage

o Maintain resilience

Other duties as assigned.

Minimum Requirements:

Graduate of an accredited program of registered professional nursing; Bachelors in Nursing required; Masters in Nursing preferred.

Experience Requirement: Two (2) or more years of experience at the RN level in both certified (CHHA) home health care and in clinical management.

License: Current and unexpired NYS RN license, unencumbered, required.

• Medicare home health experience and management experience required.
• Organized, detail-oriented, and possesses effective communication skills both orally and in writing.
• Understands the delivery of home health care and is able to problem-solve effectively.
• Capable of prioritizing and handling multiple tasks of critical importance simultaneously.
• Functions well in an atmosphere of change and interruption.
• Effective management skills.
• Must possess a valid NYS driver’s license and automobile liability insurance.
• Must have dependable transportation and able to drive in all types of weather.

Job Type: Full-time

Pay: $90,000.00 - $140,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Professional development assistance
• Referral program
• Retirement plan
• Tuition reimbursement
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Holidays
• On call
• Weekends as needed

Application Question(s):

• This position requires confidence and expert skills in navigating / utilizing an EMR system (home care type). Describe your EMR experience and systems used:
• This position will require travel between our two offices (Glens Falls and Plattsburgh routinely). Are you still interested?

Shift availability:

• Day Shift (Required)

Ability to Commute:

• Glens Falls, NY (Required)

Ability to Relocate:

• Glens Falls, NY: Relocate before starting work (Required)

Willingness to travel:

• 50% (Required)

Work Location: In person