Job Title: Assessment Nurse Manager
Department: Intake Clinical Eligibility
Reports To: Assistant Director
Incumbent ensures that prospective new and active enrollees/members are appropriately screened by assessment staff to meet eligibility requirements. Ensures that an initial and ongoing service plans are developed implemented and communicated with all relevant parties. Incumbent will direct the daily operations of scheduling, staffing needs, clinical coordination and liaison with Human Resource Administration (HRA). Participates in the training and marketing initiatives to support awareness in the community and growth of plan.
Frequently communicates complex information and interacts via electronic documentation/tools. This is a paperless work environment requiring daily hands-on administration of multiple electronic Patient Health Information (PHI) databases and security requirement tools such as encryption. These systems include, but are not limited to, CCMS (CareEnhance Clinical Management Software), Sunguard Macess Service Module (electronic archiving), RightFax, VoIP, Virtual Work Platforms (using VPN), scanning and creating .pdf files (Adobe Acrobat), and MS Office 2010 software (such as Word and Outlook).
Essential Duties and Responsibilities:
· Leads and manages daily operations (oversight of scheduling, clinical consultations, staffing) of teams of Intake and Reassessment Nurses
• Ensures accurate and comprehensive completion of assessments and required State approved and internal documents including SAAM, MMSE and all nursing documents
• Ensures accurate SAAM scoring and Delta entries
• Ensures smooth transition and appropriate training/re-training from SAAM to UAS for all staffs
• Maintains Staffing Patterns to ensure that appropriate assessments and reassessments are completed within time frames to determine initial eligibility and continued eligibility.
• Supervises and monitors productivity and accountability of nursing staff including assessment visits and management of service plans including home care hours.
• Acts as a liaison with HRA in clarifying assessment information and follow up.
• Acts as resource to all assessment RN staff members in providing guidance, support, professional consultation and feedback to ensure accuracy, timeliness and clinical skill
• May conduct assessment visits as needed
· Coordinates and communicates services that are to be implemented or revised with SHP Care Management Teams for new enrollees or active members
• Coordinates all requests for additional visits (ie: PRI/Screen, unscheduled reassessments) with Care Team Supervisors. Prioritizes all unscheduled visits and triages requests.
• Communicates with HRA, CHHAs or other health care providers to notify of start of care with SHP and discharge of cases if needed.
• Communicates to family members, new enrollees and referral sources outcome of assessment, reasons for and provides alternative health care recommendations if not serviced by Senior Health Partners.
• Documents all efforts
• Coordinates and communicates with MLTCP Managers dis-enrollment or Significant change SAAM’s
· Participates in all aspects of personnel management, including maintaining staffing patterns, to ensure appropriate orientation, training/ongoing support, performance management and remediary actions (as applicable).
• Ensures that probationary and annual performance appraisals are completed in an objective manner; that employees are encouraged to complete their self evaluation and that appraisals are completed in a timely manner.
• In collaboration with QA department staff, coordinates orientation and in-service programs to meet regulatory requirements and support performance improvement.
• Meets regularly with direct reports to review goals, trends and performance measures and to facilitate change
• Participates in the continued development of the staff to improve the team decision-making process.
· Supports the education of participants, family members and Care Team.
• Provides training regarding the issues of care for the frail elderly in community settings including self-care techniques and prevention strategies as needed
• Participates in staff development and quality improvement projects
• Provides feedback to the home care agencies and Care Team regarding home care issues and areas of performance improvement.
Required: Associate’s degree in Nursing.
Preferred: Bachelor’s degree or BSN.
Licenses, certificates, etc.
Required: NYS RN license.
Work Related Skills and Experience:
· Capable without intimidation of toggling between many databases systems and varied applications.
· Intermediate skills using a Corporate email system (e.g. Outlook, Lotus Notes), browsing the Internet and using a medical records database for patient health information (PHI).
· Intermediate level Microsoft Word, Excel and PowerPoint.
· Fluent assessments MMSEs and SAAMs or similar and the ability to teach staff in the utilization thereof.
· 3 years of U.S. based field work experience of which at least one year is in the following areas:
· Geriatrics, Home Care, Discharge Planning, Case Management or Medical Surgical Nursing.
· Knowledge of Department of Health (DOH) and CMS regulations.
· 1 year with geriatric population and excellent assessment skills with frail adult population.
· Work experience as a Team Leader or similar capacity delegating and directing project team members.
· Experience managing patient/client information in a shared network environment using paperless database modules and archival systems.
· Experience with multiple Medicaid managed care plan products such as, Family Health Plus (FHP), Eastern Benefits System (EBS), Federal Employee Program (FEP).
· Experience problem-solving with successful results in an environment containing frequent interruptions, changing priorities and short deadlines.
· Able to multi-task, organize granular details and independently manage time in accordance with routinely changing priorities.
· Skilled in planning and coordinating nursing care for individuals including care-taker education.
· Able to perform duties in accordance with ANA Code for Professional Nurses.
Experience working with one or more of the following systems:
· CareEnhance Clinical Management Software (CCMS)
· Electronic medical record (EMR) database containing patient health information (PHI)
· Security tools such as encryption
· Sunguard Macess Service Module (electronic archiving)
· Virtual work platforms (VPN)
Complete fluency in reading, writing or speaking in Spanish, Russian, French, Creole, Mandarin, Shanghainese, Suzho, Cantonese, Toishanese, Fujianese, Fukanese, Fuzhounese Hindi, Bengali, Urdu or Nepali.
3 years in a supervisory role conducting interviews, handling employee relations including corrective actions and annual performance evaluations.
While performing the duties of this job, this employee will be climbing, crouching, reaching, bending, overhead lifting, standing, driving and lifting/carrying and pushing/pulling 1-50lbs. This employee will also be frequently sitting, keying, traveling and lifting/carrying and pushing/pulling 1-10lbs.
This employee will frequently be indoors, outdoors and cold.
Healthfirst offers a comprehensive benefits package including, but not limited to:
· Basic Life and Accident Insurance
· Supplemental Life insurance
· Dependent Life Insurance
· Short-Term Disability
· Buy-Up Short Term Disability
· Long-Term Disability
· Flexible Reimbursement Accounts
· Healthfirst 401(k) Plan
· Employee Assistance Plan
· Commuter Savings Program
· Eligibility for Annual Bonuses
· Generous Paid Time Off program
· Paid Candidate Referral Program
Conditions of Employment: Employee must pass pre-employment screening which includes a background check and drug testing. Employee must present documentation to verify minimum of high school educational requirement.
Disclaimer: The statements herein are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.
All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, national origin, disability or veteran status.