Care Manager Interview Day - October 21st (In person)
Company: NYU Langone Health
Location: New York
Posted on: October 14, 2024
Job Description:
is a world-class, patient-centered, integrated academic medical
center, known for its excellence in clinical care, research, and
education. It comprises more than 200 locations throughout the New
York area, including , , and a level 1 trauma center. Also part of
NYU Langone Health is the , a National Cancer Institute designated
comprehensive cancer center, and , which since 1841 has trained
thousands of physicians and scientists who have helped to shape the
course of medical history. At NYU Langone Health, equity,
diversity, and inclusion are fundamental values. We strive to be a
place where our exceptionally talented faculty, staff, and students
of all identities can thrive. We embrace diversity, inclusion, and
individual skills, ideas, and knowledge. For more information, go
to -, and interact with us on -, -, -, -, -, - -and -.On Monday,
October 21st, NYU Langone Health will be hosting an in person -Care
Manager Department RN Interview Day from 10:00AM-4:30PM. - We are
seeking care management experience OR at least two years of
inpatient experience nurses to staff our Care Management Department
for full time, day shift (with weekend requirement) positions only.
- The position -is for our Care Management Department in Manhattan.
- The position is ONSITE in Manhattan.Qualified candidates must
have:
- A BSN
- Inpatient or care management experience - 2 years
minimum
- Current or in process NYS RN licensure
- The ability to work full-time and day shift (with four weekend
days required per month)Those selected to participate in the
interview day will be contacted by our Talent Acquisition team. -
Job Responsibilities:
- Identifies cases that require peer review in accordance with
the clinical indicators and criteria developed by the clinical
department Identifies trends in care processes or services that may
provide opportunities for improvement in a patient population or
clinical service Refers appropriately cases that require peer
review in accordance with the clinical indicators and criteria
developed by the clinical department Takes initiative to
participate in a quality/process improvement initiative
Collaborates with the interdisciplinary team to create solutions
and take corrective actions to address issues resulting in
variances in the plan of care
- Applies customary protocols pathways evidence based processes
and other means of managing patient care Utilizes protocols
pathways and order sets to formulate communicate and ensure
implementation of the patient plan of care Utilizes
multidisciplinary team to address individualized patient needs
Develops realistic goals with multidisciplinary team for patient to
achieve milestone activities within appropriate timeframes
Demonstrates flexibility with plan of care to meet patient
needs
- Supports the mission philosophy standards goals and objectives
of NYU Hospitals Center and Care Management Program Contributes to
the development of the goals and objectives of the Care Management
Program consistent with the objectives of NYU Hospitals Center
Understands applies and supports departmental/hospital policies
procedures and standards Observes at all times legal and ethical
considerations pertaining to patients and hospital personnel
Initiates programs for improving cost effectiveness in coordination
of patient care Assists managers to create a participative
environment in department based meetings and other activities
Analyzes and develops systems to improve processes and outcomes in
collaboration with managers
- Communicates the outcome of chart review and managed care
company telephonic review with the health care team as appropriate
Conducts accurate reviews using CMS Milliman Care Guidelines and
the patients chart as the primary source of information Performs
and documents initial certification and continued stay reviews
within appropriate time frame and in appropriate system Documents
obtained payor authorization in a complete timely and concise
manner Maintains follow up communication with payor as required for
authorization of hospital stay Notifies health care team of
outcomes of communication with payor and authorization status
Notifies departmental manager of all unresolved utilization
problems/issues
- Acts as advocate/facilitator in all cases with insurance
related issues delays in treatments and/or diagnostic tests
Collaborates with the interdisciplinary team to maintain
appropriate levels of care to facilitate movement of the patient
through the continuum Identifies and documents delays in treatment
and processes Understands basic reimbursement systems and
identifies potential payor issues relative to delays in treatments
and/or diagnostic tests Assists in developing strategies to
decrease avoidable days Demonstrates and communicates the value of
avoidable days and/or additional documentation to justify acute
inpatient hospitalization
- Participates in departmental interdisciplinary hospital and
Medical Board committees as appropriate Participates in
departmental interdisciplinary hospital and Medical Board
committees as requested Represents the voice of Care Management in
committee participation Completes committee assignments as
requested Provides feedback and periodic reports to Care Management
at departmental meetings and senior managers on relevant
issues
- Assesses patient and medical record documentation for
appropriate acute admission and level of care quality and safety
indicators and plans for discharge Assesses patient and medical
record documentation to identify medical necessity and
appropriateness of admission and continued stay using pre
established clinical criteria i e Milliman Care Guidelines CMS
according to hospital policy Ensures that the physicians
documentation supports level of care Collaborates with physician
when additional documentation needed to support level of care
Communicates appropriate level of care to the health care team
Utilizes patient assessment information to identify quality and
safety indicators to monitor during hospital stay Performs initial
and ongoing assessment of patient/family needs for discharge
planning and communicates findings to interdisciplinary team
- Performs systematic assessment and reassessment of patient and
family/significant other considering clinical presentation cultural
and religious influences individual experiences available resources
environmental factors as well as health behaviors and practices
Considers all aspects of patient/family assessment findings
Understands medical plan of care and is able to communicate
pertinent findings from patient assessment Monitors medical plan of
care to determine outcome of treatment and revise patient
assessment as necessary Facilitates appropriate consults based on
patient assessment to ensure timely delivery of care Identifies
cultural and religious influences on illness
- Formulates the plan of care along with the patient and family
based on communication with the attending physician s expected
goals of care and length of stay; articulates knowledge of the plan
of care through an understanding of patients diagnosis prognosis
care needs and desired outcomes Considers assessment findings and
collaborates with the attending physician s /hospitalist to
establish the expected goals of care and LOS Collaboratively
participates in the development of an interdisciplinary plan of
care that is individualized to the patients condition or needs
Focuses the care plan on quality of life effective utilization of
resources and facilitates goal achievement and movement through the
continuum of care Proactively identifies hospital services and
available resources to meet patients needs Reviews patient history
and re assess prognosis and care needs to achieve desired outcomes
Assesses patient/family needs for advance care planning Confers
with attending physician/hospitalist and health care team regarding
variances from anticipated plan of care
- Works collaboratively with attending physician consulting
physician s and other disciplines to identify develop implement and
coordinate an appropriate plan of care that maximizes individual
patient/family preference and enhances quality access and cost
effective outcomes Ensures patients individualized plan of care is
collaborative and multidisciplinary by working with patient/family
attending physician/hospitalist and health care team members
Coordinates care based on individual needs expected goals and
length of stay Facilitates interdisciplinary plan of care
interventions Communicates effectively with attending
physician/hospitalist and members of health care team to enhance
patient care in a positive environment
- Assesses patient and family responses to interdisciplinary plan
of care and care management interventions and adapts interventions
to achieve optimal outcomes Collaborates with patient family
interdisciplinary team for agreement with treatment goals
timeframes and coordination of care Works with the
interdisciplinary team to facilitate adjustments to the care plan
to promote enhanced outcomes Intervenes as care manager in a manner
that is consistent with the established plan of care Prioritizes
and organizes interventions Implements interventions in a safe
timely and appropriate manner
- Documents assessments findings progress interventions and
recommendations in a care management software system and/or medical
record according to established standards Documentation meets
standards in accordance with departmental and hospital policy and
procedures Documents assessments findings progress interventions
and recommendations in Canopy and ECIN Care Management and ICIS
systems within established timeframes Documents revisions in
diagnoses plan of care and outcomes Documents patients responses to
interventions with appropriate consideration of patient
confidentiality
- Contributes to the development of new strategies to address
transitional planning needs of specific assigned patient
populations improved care coordination and care management delivery
Utilizes current literature to facilitate clinical/care management
practice changes Participates in the development and revision of
clinical/care management practice standards Engages in strategies
to measure improvements in quality of care that directly result
from care management interventions Utilizes evaluative and outcomes
data to improve care management services
- Participates in development of quality indicators and analysis
of such indicators per departmental quality performance improvement
plan Collaborates with members of the interdisciplinary team to
develop quality indicators to measure performance improvement per
departmental quality performance improvement plan Conducts required
and initiated monitoring activities report to respective
disciplines as indicated Evaluates outcomes of monitoring and
adjusts targets and reporting as indicated Facilitates and ensures
sharing of data and outcomes with interdisciplinary team
- Uses evidence based practice to drive improvement strategies
Promotes health care outcomes in conjunction with evidence based
guidelines Identifies areas requiring further study Develops
strategies to utilize data findings for individual patients as well
as program Recommends interdisciplinary evidence based practice
changes
- Facilitates effective coordination of interdisciplinary
unit/physician team e g Firm on the Medical Service rounds to
identify the patients clinical management needs progression of care
identification of barriers appropriate discharge plan and
anticipated discharge date Assumes a leadership role to coordinate
and facilitate daily interdisciplinary unit/physician team rounds
LOS management and discharge process Collaborates with the
interdisciplinary team to maintain appropriate levels of care to
expedite the movement of the patient to alternate levels of care
throughout the continuum Reviews monitors and individualizes on an
ongoing basis each patients plan of care based on diagnosis and
assessment of patient/family needs Identifies internal obstacles to
efficiency and good patient outcomes and intervenes with healthcare
team to eliminate when possible Identifies a follow up time frame
to accomplish the recommended plan Communicates patient status and
needs to the next level of care for discharge planning
- Facilitates timely and appropriate communication among
attending physicians nurse practitioners physician assistants
patients family members other members of the health care team
external providers and payers Refers significant clinical issues
per protocol to the attending physician and/or hospitalist or to
the designated consultants Utilizes chief of service/physician
advisor to address unresolved clinical and interdisciplinary issues
Participates and contributes as a regular member of
interdisciplinary rounds to communicate and receive pertinent
information Utilizes critical thinking skills and assists others to
identify and resolve potential and existing problems related to
coordination of patient care Determines the best method to
communicate with the interdisciplinary team about different kinds
of issues i e direct contact telephoning emailing and paging
Collaborates with attending physician/hospitalist regarding
patients achievement of therapeutic regimen
- Ensures identification of variances and the development of
appropriate contingency plans for each phase of care in the event
of patient health complications or systems barriers Communicates
with the attending physician/hospitalist patient/family and staff
regarding alteration in plan Monitors test results patient
responses to interventions health status and makes recommendations
for revisions to treatment plan based on patient need and responses
Evaluates and communicates changes in patients clinical condition
timely Documents medical plan of care and reflects patients
progress in meeting prescribed plan
- Effectively communicates information relative to a potential
denial to the appropriate members of the health care team
Communicates timely complete and accurate information relative to a
potential denial to the appropriate members of the health care team
Demonstrates an understanding of the peer to peer appeal process
for authorization of acute inpatient hospitalization Effectively
monitors documents and informs members of the health care team the
outcome of the peer to peer appeal process Demonstrates an
understanding of CMS Milliman Care Guidelines relative to the
patients diagnosis and condition when providing a clinical review
to the payor to prevent a potential denial Effectively communicates
the impact on reimbursement to the hospital for potentially denied
days to the health care team Utilizes the chief of
service/physician advisor per departmental guidelines
- Coordinates discharge appeals or issuance of Hospital Notices
in accordance with State and Federal Regulations and departmental
guidelines Demonstrates an understanding of the CMS and NY State
regulations for discharge appeals and issuance of Hospital Notices
Follows procedures for issuing Hospital Notices when appropriate
and communicate necessary information to healthcare team relative
to patients benefits Facilitates issuance of the Important Message
from Medicare within 24 48 hours before discharge and the Detailed
Notice of Discharge if indicated Effectively communicates the
initiation of a discharge appeal to the health care team
Coordinates the collection of medical record documentation for
review by the review agent i e IPRO managed care carrier
Communicates outcome of discharge appeal to patient/family and
health care team
- Educates nursing medical and ancillary staff about care
management role relevant clinical criteria and resources available
for patients as well as regulatory and managed care requirements
Demonstrates an understanding of the vision and goals of the care
management program Demonstrates an understanding of the core
functions of the care management role Demonstrates an understanding
of and effectively communicates information relative to clinical
criteria and resources available for patients/families to the
healthcare team Serves as a resource for other members of the
health care team by participating in or conducting formal/informal
in service education as needed Identifies own practice abilities
and limitations and obtains instruction and supervision as
necessary This includes seeking education for self development
- Facilitates patient/family knowledge of and participation in
the plan of care Identifies long and short term needs based on a
comprehensive assessment and anticipate outcomes Proactively
identifies hospital services and available resources to meet the
patients needs Ensures that patients individualized plan of care is
collaborative and multidisciplinary by working with patient
physician and health care team members Focuses the care plan on
quality of life effective utilization of resources and facilitates
goal achievement and movement through the continuum of care
Collaborates with patient/family physician and health care team for
final agreement with treatment goals timeframes and coordination of
care Develops additional and contingency plan options with
patient/family when planning for discharge
- Participates in development and implementation of appropriate
patient/family education material pertinent to population served
Contributes to the development of patient/family education material
for disease management Facilitates patient/family education and
understanding to prevent risk behaviors and to promote and achieve
good health outcomes Educates the patient/family and provide
support in moving toward self care Educates and assists in
facilitating patient/family access to necessary and appropriate
health care services
- Maintains current clinical knowledge in area of review and
patient population Achieves and maintains current professional
licensure national certification and/or higher education in case
management or in a health and human services profession directly
related to case management practice Maintains continuing competence
appropriate to case management and to professional licensure or
professional certification Provides only case management services
within scope of practice Refers patient to another source for
services outside scope of practice Maintains continuing competence
appropriate to case management and to professional licensure or
professional certification Maintains annual mandatory education
requirements Maintains membership in professional
organizations
- Promotes own professional growth and development in care
management role Identifies own practice abilities and limitations
and obtains instruction and supervision as necessary This includes
seeking education for self development Participates in and utilizes
peer review to identify areas for improvement in practice and
leadership Achieves previously established personal professional
goals Participates in departmental education sessions
- Evaluates appropriateness of alternate level of care for
optimal delivery of services to the patient and for resource
efficiency Assesses the need for continued acute care services
Anticipates barriers to discharge Assesses and re assesses
appropriate discharge plans and options based on clinical need and
patient/family resources Collaborates with other members of the
interdisciplinary team to dual plan discharge options Facilitates
patient/family team meetings to discuss discharge plan and
options
- Communicates information documented in the medical record that
identifies a potential event/occurrence to the Risk Manager
Identifies quality and risk management issues; refer issues for
corrective action as appropriate Documents a potential
event/occurrence and communications to the Risk Manager into Canopy
within established timeframes
- Serves as resource for education of patients families peers
staff and physicians Facilitates patient/family teaching as soon as
learning needs are identified Provides patient/family education
regarding post acute services community resources or other as needs
identified Role models expert professional care management
practices Supports a constructive environment of learning and
development of mutual respect with health care team and peers
Facilitates staff access to outside educational opportunities
through sharing of program announcements etcMinimum
Qualifications:
To qualify you must have a Professional Registered Nurse in New
York State with current registration Education: BSN required or
graduate of an accredited RN program with BS in related health care
field Experience: Three to five years clinical experience acute
medical surgical preferred or in the care of the population to be
care managed Competencies: Evidence of excellent interpersonal
skills effective communication negotiation and conflict management
skills; creative problem solving and clinical leadership; change
management organizational and time management skills Ability to
apply critical thinking and clinical expertise toward achievement
of specific outcomes Previously demonstrated ability to foster
strong collaboration with co workers peers physicians nursing and
ancillary departmental support staff Knowledge of Microsoft Office
and demonstrated proficiency in managing software such as Eclipsys
Sunrise Manager Canopy and ECIN.
Required Licenses: Registered Nurse License-NYS, Basic Life Support
CertQualified candidates must be able to effectively communicate
with all levels of the organization.
NYU Langone Health provides its staff with far more than just a
place to work. Rather, we are an institution you can be proud of,
an institution where you'll feel good about devoting your time and
your talents.
NYU Langone Health is an equal opportunity and affirmative action
employer committed to diversity and inclusion in all aspects of
recruiting and employment. All qualified individuals are encouraged
to apply and will receive consideration without regard to race,
color, gender, gender identity or expression, sex, sexual
orientation, transgender status, gender dysphoria, national origin,
age, religion, disability, military and veteran status, marital or
parental status, citizenship status, genetic information or any
other factor which cannot lawfully be used as a basis for an
employment decision. We require applications to be completed
online.
If you wish to view NYU Langone Health's EEO policies, please .
Please to view the Federal "EEO is the law" poster or visit for
more information.NYU Langone Health provides a salary range to
comply with the New York state Law on Salary Transparency in Job
Advertisements. The salary range for the role is $132,213.80 -
$181,713.80 Annually. Actual salaries depend on a variety of
factors, including experience, specialty, education, and hospital
need. The salary range or contractual rate listed does not include
bonuses/incentive, differential pay or other forms of compensation
or benefits.To view the Pay Transparency Notice, please
Keywords: NYU Langone Health, West Hartford , Care Manager Interview Day - October 21st (In person), Executive , New York, Connecticut
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