ISNP Clinical Manager (Part-Time)

75 Vanderbilt Ave, Staten Island, NY 10304, USA

Req #11917

Monday, April 29, 2024

Centers Plan for Healthy Living's goal is to create the ultimate healthcare experience that provides our members, their families, healthcare decision makers, and general caregivers with the guidance and plans they need for healthy living.

Summary

Assist the Director in the coordination, implementation, monitoring and evaluation of quality and utilization activities related to outcomes management in accordance with CPHL, State and Federal mandates and regulations.

Essential Functions

Review hospital transfer cases (treat & release and admissions) w a written summary which will include care rendered the days leading up to transfer, determination of avoidable vs unavoidable with recommendations for improvement and discussion with assigned NPs.

Review current POC for members identified as complex, i.e., uncontrolled HTN and DM, high risk for hospital readmission and members with high utilization cost and meet with assigned NPs as needed.

Monthly clinical condition audits (CCIP)

Telephone support for NPs

Competencies

Computer capabilities

Familiarity with data analysis & utilization trending

Excellent interpersonal skills, negotiation skills, presentation skills

Excellent verbal and written skills

Excellent training and audit skills

Supervisory Responsibility

Minimum of three years supervisory experience with a managed care or insurance company

Work Environment

This job operates in a professional environment. This role routinely uses standard equipment such as computers, phones, and photocopiers.

Physical Demands

This is largely a sedentary role; however, some filing is required. This would require the ability to lift files, open filing cabinets and bend or stand as necessary.

Position Type and Expected Hours of Work

This is a W-2 based position. Some travel to nursing facilities.

Required Education and Experience

Masters Level Prepared, Nurse Practitioner, preferably Geriatric Nurse Practitioner

Knowledge and working experience with Medicare, Medicaid and state/federal health care regulations

NYS Nurse Practitioner license

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Centers Plan For Healthy Living is committed to leveraging the diverse backgrounds, perspectives and experiences of our workforce to create opportunities for our employees and our business. We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or any other characteristic protected by law and will not be denied employment.

Other details

• Pay Type Hourly

• Hiring Rate $100.00

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• 75 Vanderbilt Ave, Staten Island, NY 10304, USA