Director of Educational Services, Rn

2 weeks ago

Bronx, United States CenterLight HealthCare, Inc Full time

**JOB PURPOSE**:
The Clinical Assessment Outreach Manager is accountable for educating referral sources and prospects about CenterLight’s Program of All-Inclusive Care for the Elderly (PACE), including services offered and Medicare and Medicaid eligibility. This position is tasked with conducting outreach and effectively guiding prospects through the onboarding process and growth of the company. This person will conduct clinical assessments utilizing the Uniform Assessment System of New York (UAS-NY) and will document clinical and other enrollment information in the electronic record system. This position is also responsible for helping develop efficient and effective systems that ensure quality care and compliance with state, PACE, and organizational regulatory requirements.

**JOB RESPONSIBILITIES**:

- Meet referral and enrollment goals set forth by management by building relationships with referral partners to create engagement opportunities with prospective enrollees and their caregivers.
- Ensure high performance and productivity of pre-enrollment verifications of Medicare, Medicaid, and PACE eligibility.
- Educate referral sources, prospective participants/caregivers, and other audiences on relevant PACE program benefits as well as CenterLight’s initiatives and projects. Identify differentiators from other healthcare options and isolate key value propositions in relation to audience group and specific needs.
- Provide program education through lectures, presentations, events, meetings or other necessary communications with community and business stakeholders to facilitate PACE referral generation.
- Work with the Events Supervisor in identifying appropriate events, community partners or other resources and opportunities to educate the community about CenterLight PACE and provide education / technical / administrative support for planning and execution.
- Maintain knowledge of all applicable CMS, DOH and PACE-specific guidelines, including organizational and departmental policies and procedures. Ensure familiarity with & compliance, amongst staff, with state & federal laws regarding Medicaid and Medicare Eligibility and Enrollment regulations.
- Work closely with the Intake Navigators and Account Managers to schedule in-home or virtual pre-enrollment assessment appointments with prospective participants.
- Conduct pre-enrollment assessments using the UAS to determine eligibility of the prospective participant and confirm if they require greater than 120 days of Community Based Long Term Care Long Term Care (CBLTC) Services.
- Complete the Tasking Tool to determine appropriate home assistance with ADLs/IADLs combined with attendance at the CenterLight PACE site.
- Document all interactions and outcomes in the designated clinical management/electronic record system.
- Work with the quality review team to ensure accuracy and completeness of all necessary documentation in the Health Commerce System and in the electronic record system.
- Work with the participant and/or their family/caregiver to develop the 30-day service plan and obtain enrollment agreement documentation during home visit or other setting agreed upon with prospect.
- Assist with administrative functions of the program, including but not limited to, putting together informational handouts/packets from approved marketing materials, following up on referrals and appointments, regular tracking and reporting of daily activities and compiling statistical data and reports.
- Work collaboratively with the Compliance and the Marketing departments in developing necessary outreach and intake operations related materials.
- Advise on operational process improvements that may positively impact enrollment turnaround, scheduling logistics, expense/financial-related efficiencies, engagement strategies, reporting and other critical touchpoints.
- Regularly review key performance metrics and analytics to improve process flows and/or quality of work.
- Interview, hire, train, supervise, progressively discipline, and counsel all staff in the department. Support new staff with onboarding to ensure supportive, collaborative, and efficient transition to the Business Development and Clinical Intake Teams.
- Meet goals set forth by the company and pivot when necessary.
- Develop workflows and staffing deployments in anticipation of new service areas.
- 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**:BS in Nursing or other health-related area, preferred.

**Experience**:

- 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 tra

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