Current jobs related to Accountable Care Manager - New York - NYC Health Hospitals
-
Account Manager, Contracting
4 weeks ago
New York, United States Village Care Full timeJoin VillageCare as a Full-Time Account Manager in Contracting, where you will play a pivotal role in shaping health plan agreements. This position offers the unique opportunity to engage with key stakeholders, ensuring quality and excellence in healthcare delivery. Enjoy the flexibility of a work-from-home environment, allowing you to balance professional...
-
Junior Account Manager
3 days ago
New York, New York, United States Village Care Full timeAbout VillageCareVillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and managed care services. Our mission is to promote healing, better health, and well-being to the fullest extent possible.We have delivered quality health care services to...
-
Senior Accountant
4 weeks ago
New York, New York, United States Village Care Full timeAbout the RoleVillageCare is seeking a highly skilled Senior Accountant to join our dynamic team. As a Senior Accountant, you will play a crucial role in overseeing account reconciliations, journal entries, and account reviews for month-end closing, quarterly reporting, and annual audit tasks.Key ResponsibilitiesOversee account reconciliations, journal...
-
Accountable Care Manager
1 week ago
New York, New York, United States NYC Health Hospitals Full timeJob SummaryWe are seeking a highly skilled Accountable Care Manager to join our team at NYC Health Hospitals. As a key member of our care coordination team, you will play a critical role in ensuring seamless transitions of care for our patients.Key Responsibilities:Review patient charts to ensure documentation supports plan of care and justifies admission...
-
Accounts Payable Assistant
1 week ago
New York, New York, United States Village Care Full timeJob SummaryVillageCare is seeking a detail-oriented and organized Accounts Payable Assistant to join our team. As an Accounts Payable Assistant, you will play a vital role in maintaining the integrity and accuracy of our financial operations.Key ResponsibilitiesEnsure timely and proper payment of invoices and check requests while adhering to established...
-
Accountant
4 weeks ago
New York, New York, United States Texas Family Care Network Full timeJob SummaryThe Texas Family Care Network is seeking a highly skilled Accountant to join their team. As an Accountant, you will play a crucial role in the fiscal operations of the organization, ensuring accurate and timely financial reporting and compliance with regulatory requirements.Key ResponsibilitiesPrepare and review financial statements, including...
-
Accounting Manager
4 weeks ago
New York, New York, United States American Hydro Full timeJob Title: Accounting ManagerAt American Hydro, we are seeking an experienced Accounting Manager to join our team in York, PA. As a key member of our finance department, you will be responsible for planning and directing the accounting activities of the organization.Key Responsibilities:Manage personnel in the accounting department, including accounts...
-
Accounting Manager
1 month ago
New York, New York, United States American Hydro Full timeJob Title: Accounting ManagerAt American Hydro, we are seeking a highly skilled Accounting Manager to join our team in York, PA. As a key member of our finance department, you will be responsible for planning and directing the accounting activities of the organization.Key Responsibilities:Manage personnel in the accounting department, including accounts...
-
Accounting Manager
3 days ago
New York, New York, United States DocGo Full timeAbout DocGo:DocGo is a pioneering healthcare company that is revolutionizing the industry with its innovative care delivery platform. This platform includes mobile health services, population health, remote patient monitoring, and ambulance services.By disrupting the traditional four-wall healthcare system, DocGo provides high-quality, affordable care to...
-
Accounting Manager
3 days ago
New York, New York, United States Garden Spot Communities Full timeAccounting Manager Job DescriptionWe are seeking an experienced Accounting Manager to join our team at Garden Spot Communities. As an Accounting Manager, you will be responsible for overseeing the finance department staff and managing schedules to ensure timely workflows in the areas of Billing, Cash Receipts, and Accounts Payable. You will also be...
-
Accounting Manager
2 weeks ago
New York, New York, United States Soho House & Co. Full timeJob Title: Accounting ManagerJoin Soho House & Co. as an Accounting Manager and take on a challenging role that requires strong accounting management capabilities. As a key member of our finance team, you will be responsible for supervising staff, reviewing workpapers, and preparing various statutory financial statements.Key Responsibilities:Provide...
-
Accounting Officer
1 week ago
New York, New York, United States Complete Home Care Services Full timeAccounting Officer Job DescriptionAt Complete Home Care Services, we are seeking a highly skilled Accounting Officer to join our team. The successful candidate will be responsible for managing the company's financial transactions, ensuring accuracy and compliance with accounting standards.Key Responsibilities:Prepare and process financial transactions,...
-
Account Manager
1 month ago
New York, United States Hexaware Technologies Full timeWhat Working at Hexaware offers:Hexaware is a dynamic and innovative IT organization committed to delivering cutting-edge solutions to our clients worldwide. We pride ourselves on fostering a collaborative and inclusive work environment where every team member is valued and empowered to succeed.Hexaware provides access to a vast array of tools that enhance,...
-
Care Manager
4 weeks ago
New York, New York, United States Care Collab Full timeJob SummaryCareCollab is seeking a skilled Care Manager to lead the engagement and coordination of comprehensive care and services for high-utilization Medicaid members with chronic medical and behavioral health conditions. This role is crucial in addressing the holistic needs of our members, including behavioral, medical, and social aspects.Key...
-
Accounting Manager
1 week ago
New York, New York, United States Vibrant Emotional Health Full timeJob Title: Accounting ManagerJob Summary:The Accounting Manager is responsible for ensuring accurate and timely financial reporting, as well as overseeing the management of accounting staff. This position requires collaboration with various departments to provide financial information and support.Key Responsibilities:Supervise and mentor accounting staff to...
-
Accounting Manager
3 days ago
New York, New York, United States Matheny Medical and Educational Center Full timeJob SummaryMatheny Medical and Educational Center is seeking a highly skilled Accounting Manager to join our team. As a key member of our finance department, you will be responsible for maintaining an accurate accounting system, supervising the billing, accounts payable, and payroll teams, and preparing monthly internal financial reporting packages.Key...
-
Account Manager
2 weeks ago
New York, New York, United States Whatnot Full timeAbout WhatnotWhatnot is the leading livestream shopping platform in North America and Europe, revolutionizing the way people buy, sell, and discover products. Our mission is to create a community-driven marketplace that combines shopping, entertainment, and social interaction.Job SummaryWe are seeking an experienced Account Manager to join our team. As an...
-
Account Manager
4 weeks ago
New York, New York, United States Global Medical Response Inc Full timeNurse Navigation Account ExecutiveJoin Global Medical Response Inc as a Nurse Navigation Account Executive and play a vital role in improving access to high-quality care, decreasing unnecessary healthcare expenditures, and enhancing the overall experience, satisfaction, and clinical outcomes for the populations we serve.Key Responsibilities:Manage the...
-
Account Executive
3 weeks ago
New York, New York, United States VSP Vision Care Full timeJob SummaryWe are seeking a highly motivated and results-driven Account Executive to join our team at VSP Vision Care. As an Account Executive, you will be responsible for managing existing accounts and developing new prospects in a variety of industries. You will exercise a broad knowledge of our services, products, and marketing techniques to achieve...
-
Account Manager
3 weeks ago
New York, New York, United States NFP Full timeAbout the RoleNFP is seeking a highly skilled Account Manager to join our team. As an Account Manager, you will be responsible for working with Producers and Account Executives to service client accounts. This role requires day-to-day client servicing for a specific set of clients and entails a great deal of verbal, electronic, and written communications.Key...
Accountable Care Manager
3 months ago
Kings County Hospital Center has a rich legacy for its pioneering role in medicine. Today, with over 625 beds, our hospital remains on the cutting edge of technology and provides the most modern procedures with state-of-the-art equipment. Built in 1831 as a one room infirmary for publicly supported care of the sick, Kings County Hospital Center continues to be a leading healthcare facility whose mission is to provide care to everyone regardless of their ability to pay. The hospital provides a wide range of health services, and specialties are offered in all fields of modern medicine. More than 200 clinics provide a wide array of ambulatory care services.
At NYC Health + Hospitals, our mission is to deliver high quality care health services, without exception. Every employee takes a person-centered approach that exemplifies the ICARE values (Integrity, Compassion, Accountability, Respect, and Excellence) through empathic communication and partnerships between all persons.
Work Shifts
8:30 A.M - 4:30 P.M
Job Description
PURPOSE OF POSITION
Under general supervision, with varying degrees of latitude for independent initiative and judgment, coordinates and monitors the management of patient-centered quality care, ensuring optimal utilization of resources, service delivery, and compliance with external review requirements and applicable state and federal rules and regulations and nursing standards of care for better outcomes and improved patient experience. Facilitates patient's progress from admission through discharge and promotes strategies and forums for collaboration and mutual problem solving.
AREAS OF RESPONSIBILITIES
The Accountable Care Manager is responsible for facilitating the patient's care throughout the health care continuum. The Care Manager interfaces with patients, caregivers, physicians, nurses, social workers, and other health team members, as well as external health care agencies and community-based organizations, and other providers to expedite medically necessary, high quality, cost effective patient centered health care in the appropriate level of care setting (Ambulatory Practice, ED, Observation, Inpatient, ICU, SNF/NH, Community, Home etc.). The Care Manager applies clinical expertise and medical appropriateness criteria (clinical guidelines, clinical pathways, InterQual, Milliman Guidelines etc.) to resource utilization, revenue management, discharge planning and care coordination.
SUMMARY OF DUTIES AND RESPONSIBILITIES
Examples of Typical Tasks:
- Reviews each patient's chart. Ensures that documentation in the medical record supports plan of care and justifies admission and continued stay.
- Coordinates and/or participates in multidisciplinary rounds: reviews plan of care, and discusses estimated length of stay (LOS), need for continued hospitalization and appropriateness of resources utilization, consultations, treatment plan and discharge plan. Completes Patient Review Instrument (PRI), Screen, and all other regulatory required documents.
- Collaborates and consults with physicians and other health care professionals to reach an efficient pathway of care taking and to identify, eliminate, and implement solutions to barriers, and collects and analyzes related data, as needed.
- Communicates with hospital investigation/reimbursement department and third party payers to obtain authorizations and ensure appropriate reimbursement and provides clinical reviews and updates to managed care companies, as needed.
- Plans and implements strategies to reduce length of stay, reduce resource consumptions, and achieve positive client/patient outcomes. May coordinate the implementation of facility initiative designed to increase revenue. Maintains all related records and documentation.
- Initiates discharge planning by assessing client/patient and family needs, including but not limited to identifying non-medical psychosocial needs and post discharge medical needs. Informs patient and family of discharge planning options based on diagnosis, prognoses, resources and preferences related to home care services.
- Coordinates and facilitates timely implementation of discharge plans for patient; assures timely completion of discharge, transfer and referral forms, prescriptions, and discharge orders; arranges follow-up care, as appropriate.
- Performs or coordinates the post discharge phone call to patient and health care providers to facilitate/coordinate and verify that successful linkage to care occurred.
- Maintains effective communication with physicians, nursing staff, clients/patients, families and others related to discharge planning; coordinates with social services personnel to provide needed services.
- Contacts and directly engages patient's primary care physician and/or health care providers to support continuity of care and effective care transition.
- Interview, orient, train, precept, mentor and coach care management staff, and coordinate and direct the performance of care coordinators and social work staff performing discharge planning and assessment, including work assignment/schedule.
- Collaborate in the development of departmental policies and procedures, clinical practice guidelines and critical pathways for designated targeted diagnosis.
- Act as an educational resource and provide consultation regarding case management, discharge planning process, clinical documentation requirements and applicable federal, state, and local regulations; may identify benefits, implications, and limitations of home care.
- Initiates discharge planning/ care management interventions upon presentation by assessing the patient's needs, interviewing patient/caregiver and reviewing the interdisciplinary plan of care- utilizing risk assessment and intervention guide.
- Ensures that the interdisciplinary care plan, discharge plan & care transition are consistent with the patient's clinical course, continuing care needs and covered services.
- Perform cause analysis assessment on re-admissions/re-visits within 7, 30 days etc. & implement measures to reduce risk.
- Documents in Electronic Medical Record, Care Management systems and databases, etc. per departmental standards.
- Coordinates, reinforces, and validates discharge teaching using teach back method. Validates patient/caregiver understanding of diagnosis, signs & symptoms, medication regimen, follow up care, etc. Validates discharge readiness.
- Performs & coordinates all activities required to ensure patient's appeal rights under the Discharge Appeals program. Issues required notices to patient/caregiver and procures necessary signatures on forms- this includes ALOC, discharge notices, letters of denials and/or reinstatement within regulatory timeframes.
- Prepares & assures timely completion of regulatory/ institutional/ facility/ departmental/ organizational discharge, transfer, order, and referral forms (PRI, Screens, M11Q, 485, face to face encounter, etc.). Procures necessary signatures on forms. Validates discharge readiness
- Conducts and documents follow up phone calls to discharged patients per departmental policies/procedures, Project RED, Transitions of Care, Bundle payments, and other performance improvement guidelines/initiatives etc.
- Facilitates care delivery across the continuum with effective and validated care transitions and linkage to follow up care. This includes collaboration with community-based resources and MCOs disease management program.
- Provides reports and necessary information for continuing care to the receiving unit care manager, social worker and next level of care providers (PCP, ambulatory practice, SNF, etc.)
• Collects data on variances from screening criteria. Performs data analysis to proactively identify opportunities to improve processes and promote leading practices.
• Communicates to Risk Management all incidents, which are potentially compensable events.
• Acts as financial liaison- responds to third-party payer denials of payments. Appeals denials. Coordinates reconsideration/peer-to-peer review and appeal activity with Physicians, UR, Patients Accounts, Medical Records and Social Work etc.
• Actively participates in performance improvement projects.
• Completes and participates in performance evaluations within hospital guidelines.
• Employs a high degree of skill in all oral and written communications and personal interactions. Uses appropriate resources and methods to resolve conflicts.
• Maintains a calm, rational, professional demeanor when dealing with others, even in situations involving conflict or crisis.
• Demonstrates active collaboration with other members of the health team to achieve the Care Management programmatic goals.
• Maintains absolute adherence to Hospital and departmental policies and practices regarding confidentiality and patient's rights.
• Demonstrates knowledge and support of the Hospital's mission and values.
• Maintains clinical competency and current knowledge of regulatory, payer requirements and payer methodology (e.g. Per Diem vs. DRG) to perform job responsibilities.
• Obtains & maintains required certifications to perform job responsibilities.
• Proficient with the application of medical necessity criteria(s) and clinical guidelines (i.e. InterQual, Milliman).
• Provide care management interventions in the: Emergency department, inpatient units, across the continuum of care including the outpatient areas, and collaboration with post-acute providers e.g. Home Care, and SNF.
• Special projects as required.
• As the need arises the functions of this position will change to meet the needs of the institution.
Duties & Responsibilities
1. Reviews each patient's chart. Ensures that documentation in the medical record supports plan of care and justifies admission and continued stay.
2. Coordinates and/or participates in multidisciplinary rounds; reviews plan of care; and discusses estimated length of stay, need for continued hospitalization and appropriateness of resources utilization, consultations, treatment plan and discharge plan. Completes Patient Review Instrument (PRI).
3. Collaborates and consults with physicians and other health care professionals to reach an efficient pathway of care taking and to identify, eliminate, and implement solutions to barriers, and collects and analyzes related data, as needed.
4. Communicates with hospital investigation/reimbursement department and third party payers to obtain authorizations and ensure appropriate reimbursement, and provides clinical reviews and updates to managed care companies, as needed.
5. Plans and implements strategies to reduce length of stay, reduce resource consumption, and achieve positive client/patient outcomes. May coordinate the implementation of facility initiatives designed to increase revenue. Maintains all related records and documentation.
6. Initiates discharge planning by assessing client/patient and family needs, including but not limited to identifying non-medical psychosocial needs and post discharge medical needs. Informs patient and family of discharge planning options based on diagnosis, prognoses, resources and preferences related to home care services.
7. Coordinates and facilitates timely implementation of discharge plans for patient; assures timely completion of discharge, transfer and referral forms, prescriptions, and discharge orders; arranges follow-up care, as appropriate.
8. Performs or coordinates the post Emergency Department discharge phone call to patient and health care providers to facilitate/coordinate and verify that successful linkage to care occurred.
Minimum Qualifications
Valid New York State license and current registration to practice as a Registered Professional Nurse issued by the New York State Education Department (NYSED); and
2. A Baccalaureate degree in Nursing or related health field from an accredited college or university; and
3. Two (2) years of experience as a Registered Professional Nurse.
Department Preferences
- PRI & Screen Certification, Case/Care Management Certification preferred.
- Care/Case/UR regulations, principles & guidelines- CMS, JCAHO, DOH etc. Discharge Planning, Transitions of Care, Readmission Reduction/Prevention strategies.
- Proficient in completion of PRIs, Screens, Clinical UR/Reviews (Initial, Concurrent, Retro, Discharge).
- Proficient in MCG & InterQual criteria. Prior Care/Case/UR experience.
- Copier/Scanner/Fax, Computer.
- EMR (EPIC, QMed), AllScripts, Microsoft Suite, OnBase, and other Care Management Systems etc.
- Two (2) years of experience as a Registered Professional Nurse.
NYC Health and Hospitals offers a competitive benefits package that includes:
- Comprehensive Health Benefits for employees hired to work 20+ hrs. per week
- Retirement Savings and Pension Plans
- Loan Forgiveness Programs for eligible employees
- Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts
- College tuition discounts and professional development opportunities
- Multiple employee discounts programs
