Job description

JOB PURPOSE:

This position will ensure the effective and efficient completion of tasks associated with the clinical assessment process, including but not limited to clinical onboarding and reassessment, UAS-NY completion, comprehensive assessment, medication review, and post-hospital discharge evaluation. The Clinical Assessment Manager will follow all Department of Health policies and regulations pertaining to the Uniform Assessment System of New York (UAS-NY) as well as Intake workflows related to accurate and timely completion of UAS assessments. The Clinical Assessment Manager serves as a valuable resource to the Intake, Enrollment, and Care Delivery teams by documenting critical clinical enrollment, evaluation, and documentation of correct diagnosis, reassessment, and change in condition information in the electronic record system.

JOB RESPONSIBILITIES:

• Works closely with intake and enrollment and care delivery teams regarding in-home or virtual assessment appointments with prospective or enrolled participants (utilizing the Uniform Assessment System of New York, UAS-NY). During this visit, answers questions about the PACE program and emphasizes the unique benefits of the PACE program.
• Conducts in-home assessments for PACE participants utilizing the UAS-NY to determine initial or continued plan eligibility in accordance with the requirement need of Community Based Long Term Care Long Term Care (CBLTC) Services for greater than 120 days, and care needs.
• Evaluates and review previous assessments (of all types) to ensure documentation of any/all changes are accurately reflected in EMR. Must include narrative comments and supporting documentation and escalate issues of significant changes to Care Delivery to provide corrected resources.
• Evaluates and reviews previous primary diagnosis and medications at key intervals to ensure updated documentation is accurately reflected in EMR and match the diagnosis entered into UAS. Update and/or modify diagnosis codes and medication updates and ensure the accuracy of information. Must include narrative comments and supporting documentation and escalate issues of changes to ensure proper care and management of cases are followed.
• Promotes and educates potential referral sources about the PACE program as needed to encourage participation in the program through presentations, lectures, meetings, or other support.
• Educates potential/new PACE participants on plan benefits, services, and care delivery model.
• Escalates questions or concerns during the assessment to the quality review team to ensure appropriate completion of UAS-NY and handling of on-site issues that may require intervention.
• Completes and/or reassesses previous PCAT Tasking Tool to determine appropriate home assistance with ADLs/IADLs combined with attendance at the CenterLight PACE site. Evaluate and provide recommendations for modifications, corrections, and/or changes to previous evaluations, as well as escalates issues to the discipline manager.
• Develops the proposed service plan and obtains necessary documentation during home visit.
• Utilizes Lenavi analyzer during either the review process and/or assessment
• Documents all interactions and outcomes in the designated clinical management/electronic record system.
• Completes all assessments, notes, service plans, and other documentation timely (within 48 hours).
• Works with the quality review team to ensure accuracy and completeness of all necessary documentation in the Health Commerce System and in the electronic record system.
• Maintains knowledge of all applicable CMS/PACE guidelines and relevant organizational and departmental policies and procedures, including but not limited to, the timely conduction, finalization, and documentation of the UAS-NY.
• Remains responsive and available by phone/email for contact by CenterLight staff.
• Must be able to work some weekends and ability to travel to various boroughs.
• Provides significant clinical information to the Care Delivery team in advance of enrollment to ensure a smooth transition and appropriate opportunity for Care Delivery preparation of new participants with complex health conditions.
• Partners with Care Delivery by meeting with site leadership and IDT to provide Clinical Assessment and Intake updates, address concerns and improve the overall process.
• Serves as clinical point person in response to Care Delivery questions, concerns, or issues after enrollment.
• Engages in continuous quality improvement activities to promote optimal staff performance and participant outcomes.
• Advises on operational process improvements that may positively impact enrollment turnaround, scheduling logistics, expense/financial-related efficiencies, engagement strategies, reporting, and other critical touchpoints.
• Regularly reviews key performance metrics and analytics to improve process flows and/or quality of work.
• Maintains a schedule of at minimum 2-3 UAS-NY assessments per day according to CenterLight’s needs and availability.
• All other duties as assigned.

SALARY RANGE:

Minimum: $100,000.00

Maximum: $110,000.00

QUALIFICATIONS:

Education: Registered Nurse NY State License, BS in Nursing or other health-related area preferred

Experience:

• Three to five (3-5) years in MLTC, LTHHCP, MAP, PACE, or other managed care programs.
• Experience in working independently without significant oversight and or direction from a supervisor.
• Minimum five (5) years of experience in care/case management, disease management, population health management, utilization review, quality assurance or discharge planning (preferably within a managed care, home care, or community health organization).
• Proficiency in utilizing and analyzing UAS-NY and Lenavi.
• Experience with Customer Relationship Management platforms and clinical management systems

Other:

• Positive attitude and outlook with the ability to multi-task in a constantly changing environment
• Flexibility one weekend to meet deadlines.
• Highly motivated and self-driven individual with a willingness to work within a strict deadline environment.
• Proficiency in Microsoft Office products; report development and strong writing skills
• Excellent communication and interpersonal skills are required.
• Customer Service oriented with strong clinical management skills
• Bilingual skills are strongly preferred.JOB PURPOSE:

To directly guide a prospective Program of All-inclusive Care for the Elderly (PACE) participant through the clinical onboarding process leading to enrollment in CenterLight PACE. This position will ensure effective and efficient completion of tasks associated with the enrollment process; provide appropriate education about PACE to all relevant stakeholders; and to be a valuable resource to the Care Delivery Team by documenting critical clinical enrollment information in the electronic record system.

JOB RESPONSIBILITIES:

• Educates prospective PACE participants on plan benefits, services, and care delivery model.
• Assists with administrative functions of the program, including but not limited to, following up on referrals and appointments, as well as tracking and reporting of daily activities.
• Maintains knowledge of all applicable CMS/PACE guidelines and departmental policies and procedures.
• Works closely with intake operational team regarding in-home or virtual assessment appointments with prospective participants (utilizing the Uniform Assessment System of New York, UAS-NY). During this visit answers questions about the PACE program and emphasizes the unique benefits of the PACE program.
• Conducts the pre-enrollment UAS and determines eligibility of the prospective participant to require greater than 120 days of Community Based Long Term Care Long Term Care (CBLTC) Services.
• Works with quality review team to ensure accuracy and completeness of all necessary documentation in the Health Commerce System and in the electronic record system
• Completes the Tasking Tool to determine appropriate home assistance with ADLs/IADLs combined with attendance at the CenterLight PACE site.
• Develops the Service plan and obtains enrollment agreement documentation during home visit or other setting agreed upon with prospect.
• Complete 2-3 assessments per day (subject to change)
• Promotes and educates potential referral sources about the PACE program as needed to encourage participation in the program through presentations, lectures, meetings, or other support.
• Advises on operational process improvements that may positively impact enrollment turnaround, scheduling logistics, expense/financial-related efficiencies, engagement strategies, reporting and other critical touchpoints.
• Documents all interactions and outcomes in the designated clinical management/electronic record system
• Regularly reviews key performance metrics and analytics to improve process flows and/or quality of work.
• Supports new staff with onboarding to ensure supportive, collaborative, and efficient transition of new staff to the Clinical Intake Team
• Other tasks as required

Qualifications:

Education:

• New York State RN license or Physician’s Assistant’s certification/license

Experience:

• 3-5 years in MLTC, LTHHCP or other managed care program.
• Experience in working independently without significant oversight and or direction from a supervisor

Other:

• Willingness to travel throughout the greater NYC metropolitan region (80% of the time)
• Bilingual skills strongly preferred: Bengali, Korean, Chinese, Spanish
• Flexibility one weekend a month before submission deadline
• Highly motivated and self-driven individual with willingness to work within a strict deadline environment
• Excellent communication and interpersonal skills required
• Works inside at office locations and outside in varied weather conditions in all areas of the community, using private or public means of transportation
• Ability to sit/ stand for extended periods of time and ascend/descend stairs

Work Schedule:
M-F, 9am-5pm

Job Type: Full-time

Pay: $100,000.00 - $110,000.00 per year

Benefits:

• 401(k) matching
• Disability insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Travel reimbursement
• Tuition reimbursement
• Vision insurance

Medical specialties:

• Geriatrics
• Home Health

Standard shift:

• Day shift

Weekly schedule:

• Monday to Friday

Ability to commute/relocate:

• New York, NY 10029: Reliably commute or planning to relocate before starting work (Preferred)

Application Question(s):

• what is your salary expectations?
• Do you have UAS experience?

Work Location: In person

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