Job Information
CenterLight Health System SUPERVISOR OF CLINICAL ASSESSMENT in Flushing, New York
JOB PURPOSE:
This position will ensure effective and efficient completion of tasks associated with the clinical assessment process including but not limited to clinical onboarding and reassessment, UAS-NY completion, medication review, and post-hospital discharge evaluation. The Supervisor of Clinical Assessments 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 Supervisor of Clinical Assessments will serve as a valuable resource to the Intake and Enrollment and Care Delivery teams and oversee the review and evaluation of the Clinical Assessment team’s competencies.
JOB RESPONSIBILITIES:
Responsible for UAS-NY oversight for CenterLight PACE.
Supervise the completion of in-home assessments for PACE participants utilizing the UAS-NY to determine initial or continued plan eligibility in accordance with requirement need of Community Based Long Term Care Long Term Care (CBLTC) Services for greater than 120 days and care needs.
Supervise a team of clinical assessment nurses and reviewers to ensure the seamless and timely completion and quality of assessments.
Work with the Intake and Enrollment Department to ensure timely scheduling and completion of nurses’ assessments.
Partner with Intake and Enrollment Department to assist in oversight of prospect/participant Medicaid and/or Medicare status updates.
Supervise the development of the proposed service plan and work closely with intake and enrollment and care delivery teams to ensure timely and accurate completion and documentation of in-home or virtual assessment appointments with prospective or enrolled participants (utilizing the UAS-NY and assessments within the electronic health record).
Ensure education of potential/new PACE participants on plan benefits, services, and care delivery model.
Develop processes, policies, and workflows necessary to meet enrollments and business goals.
Maintain knowledge and updates staff/processes of all applicable CMS/NYSDOH/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.
Ensure compliance with enrollment and eligibility regulations.
Integrate new eligibility and assessment rules and CMS/NYSDOH regulations into ongoing activities.
Engage in continuous quality improvement programs and activities to promote optimal staff performance and participant outcomes.
In conjunction with the Care Delivery Department, supervise the authorization of personal care hours to ensure appropriateness and consistency with the identified needs of the participant and Medicaid regulations.
Work in conjunction with the other teams in the Business Development Department to identify referral trends that will lead to conversion of appropriate PACE candidates into the program and improve the overall quality of enrollments.
Collaborate with Care Delivery leadership and other members of the Care Delivery team. Provide significant clinical information in advance of enrollment to ensure smooth transition and appropriate opportunity for Care Delivery preparation of new participants with complex health conditions.
Partner with Care Delivery by meeting with site leadership and IDT to provide Clinical Assessment and Intake updates, address concerns and improve overall process.
Serve as clinical point person in response to Care Delivery question, concerns, or issues after enrollment.
Develop and analyze reports pertaining to the Intake and Enrollment process as it relates to the clinical program component and quality of enrollment.
Ensure that documentation is timely, accurate, appropriate and meets timeframes as determined both by the department and governmental agencies.
Has command of the rules and regulations of Medicare and Medicaid and their application to specific participant issues, conveys updates from the above and other governmental agencies to Clinical Intake staff and other stakeholders as needed.
Conduct and/or supervise the review and evaluation of competencies in the Clinical Assessment department.
Analyze department productivity and identify areas for improvement, as well as shadow members of the Clinical Assessment team to ensure quality of assessments and customer service.
Interview, hire, train, manage, and progressively discipline and counsel all staff in the department.
Engage in staff development and the development of training materials for staff’s continuing education.
Supervise relationship with contracted agencies. This includes general oversight of day-to-day operations, providing oversight and assistance to agency contracted nurses, obtaining regular vendor staffing updates so required documents are supplied to HR, reconciling invoices to ensure accuracy and approving payment to vendor, participating in strategic meetings involving contractual agreements and working process.
Help develop departmental policies, procedures, and workflows and presents to committees for approval.
Train clinical staff on assessment visits and UAS-NY requirements.
Maintains and generates required reports, including but not limited to Quarterly NYSDOH PACE Report, CMS Monthly Meeting Data, and Quality Improvement Committee Reporting.
Remain 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 for training purposes and ride-along.
Support new staff with onboarding to ensure supportive, collaborative, and efficient transition of new staff to the Clinical Assessments Team
Promote and educate potential referral sources about the PACE program as needed to encourage participation in the program through presentations, lectures, meetings, or other support.
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.
All other duties as assigned.
Schedule: 8:30AM – 5:30PM
Weekly Hours: 40
QUALIFICATIONS:
Education: New York State RN license or Physician’s Assistant’s certification / license.
Experience:
Three to five (3-5) years in MLTC, LTHHCP, MAP, PACE or other managed care program.
Experience in working independently without significant oversight and or direction from a supervisor.
Minimum of 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).
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.
Proficiency utilizing and analyzing UAS-NY and Lenavi.
Experience with Customer Relationship Management platforms and clinical management systems
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.
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 willingness to work within a strict deadline environment.
Proficiency in Microsoft office products; report development and strong writing skills
Excellent communication and interpersonal skills required.
Customer Service oriented with strong clinical management skills.
Language: Bilingual skills strongly 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.
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):$118,000.00 - $128,000.00
CenterLight Healthcare is one of the oldest non-profit comprehensive healthcare organizations in the United States. We are a premier provider of home and community-based healthcare and services in the New York metropolitan area, serving all five boroughs of New York City, as well as Westchester, Nassau and Suffolk Counties.
Through CenterLight TeamCare, we offer comprehensive healthcare and other services that enrich the lives of our participants and let them live safely at home and in their communities. TeamCare, a program of CenterLight Healthcare, is the nation’s largest not-for-profit Program of All-Inclusive Care for the Elderly (PACE). Each day, our employees serve a richly diverse population of 3,300 participants, speaking 75 languages and dialects throughout our 14 facilities. Learn more at www.centerlightteamcare.org.
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