Manager - PAC - Nurse Liaison - Northeast
Employment Type: Full-Time
OverviewThe Manager - Post -Acute, Nurse Liaison provides oversight of the Post-Acute Care (PAC) team of field Registered Nurse Supervisors and Nurse Liaisons, performing a full range of functions: Medical Necessity Reviews for Skilled Nursing Facilities in a geographic region. You will act as the primary point of contact for day to day clinical questions. You will also provide team leadership and guidance for patient centered interventions and assist in development of Post-Acute Care training, job aids, and desk level procedures.The Post-Acute Care program helps to reduce hospital readmissions of patients and has aspects of education and coaching to assist patient's transition home after a hospital stay. The program works directly with patient treatment plans, facilitates in home health care services to accomplish the treatment plan, patient goals and patient education/coaching along with adherence/compliance monitoring.ResponsibilitiesIn this Job, you will:* Convey a strong professional image, exhibit interest and positive attitude toward all assigned work.* Works collaboratively with the Medical Director team and the Market Engagement Directors to manage market performance, monitor trends and propose solutions.* Be Responsible for the day to day operations of the Post-Acute Care Program and provide team leadership and guidance. Develop processes, tools and provide clinical oversight for clinical reviewers.* Assist Product Development team in defining operational process and procedures and implements standardized operation processes to ensure compliance with CareCentrix policies, legal requirements and regulatory mandates.* Supervise all daily team activities and assign tasks and responsibilities to appropriate team members.* Monitor performance and productivity of team and individual members and take appropriate action to ensure guidelines and goals of the department are met.* Complete performance reviews and mentor the Nurse Supervisors and team members.* Ensure the confidentiality of patient documentation and provide guidance to staff in the record documentation process.* Complete audits of PAC cases and interventions to monitor outcomes, track/trend results and identify opportunities for process improvement.* Monitor department reports and provide input for team and individual staff improvement opportunities that are in accordance with department and company goals.* Set deadlines and priorities in keeping with the PAC Program and Company goals.* Participate in on-going quality assessment and performance/process improvement activities as assigned, and documents information enabling data collection and root cause analysis needed to identify opportunities for improvement.* Perform management role duties. Interact with all CareCentrix departments, CareCentrix staff, providers, hospital staff, home health agencies, referral sources and health plans to facilitate communications, answer questions, and resolve problems.* Encourage/foster an environment of teamwork, communication, collaboration and readiness for change.* Adhere to and participates in Company's mandatory HIPAA privacy program / practices and Business Ethics and Compliance programs / practices. Ensures compliance with Utilization management NCQA and URAC standards.* Participate in implementing / maintaining operational processes to ensure compliance to Company policies, legal requirements and regulatory mandates.* Attend staff development programs and obtain continuing education as required by company and licensing bodies.* Review and adhere to all Company policies and procedures and the Employee Handbook.* Participate in special projects and performs other duties as assigned.This is the job for you if:* You possess excellent communication (verbal/written), organizational and interpersonal skills.* You enjoy interacting with referral sources to facilitate communications, answer questions and resolve problems.* You can manage multiple tasks, be detail oriented, be responsive, and demonstrate independent thought and critical thinking.QualificationsYou should get in touch if: (experience, education & skills)* You are a Registered Nurse actively licensed in their home state without restrictions is required.* You have a minimum of five years' experience with thorough knowledge of healthcare delivery systems and managed care regulations, utilization management, case management, process improvement, and re-engineering processes, contract terms/stipulations, and government regulations also required.* You have at least one year of previous management and leadership experience. (Required)* You are competent and experienced with Utilization Management and Regulatory and Accrediting agency standards.CareCentrix maintains a drug-free workplace.We are an equal opportunity employer. Employment selection and related decisions are made without regard to age, race, color, national origin, religion, sex, disability, sexual orientation, gender identification, or being a qualified disabled veteran or qualified veteran of the Vietnam era or any other category protected by Federal or State law.