Healthcare Quality Care Manager

2 weeks ago

New York, New York, United States NYC Health Hospitals Full time

Company Overview

NYC Health Hospitals is a leading healthcare facility with a rich legacy of providing high-quality care to patients. With over 625 beds and state-of-the-art equipment, our hospital remains on the cutting edge of technology and medicine.

We are committed to delivering exceptional patient care and improving health outcomes through innovative approaches and collaboration with healthcare professionals. Our mission is to provide care to everyone, regardless of their ability to pay.

About the Role

We are seeking a highly skilled Healthcare Quality Care Manager to join our team. This role is responsible for coordinating and monitoring 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.

The successful candidate will facilitate patient's progress from admission through discharge and promote strategies and forums for collaboration and mutual problem-solving.

Key Responsibilities

  • Coordinates Patient Care: Reviews each patient's chart, ensures documentation supports plan of care, and justifies admission and continued stay.
  • Multidisciplinary Rounds: Coordinates and/or participates in rounds, reviews plan of care, discusses estimated length of stay, need for continued hospitalization, and appropriateness of resource utilization.
  • Clinical Expertise: Applies clinical expertise and medical appropriateness criteria to resource utilization, revenue management, discharge planning, and care coordination.
  • Collaboration: Collaborates with physicians, nurses, social workers, and other healthcare professionals to reach an efficient pathway of care and identify, eliminate, and implement solutions to barriers.
  • Communication: Communicates with hospital investigation/reimbursement department and third-party payers to obtain authorizations and ensure appropriate reimbursement.
  • Discharge Planning: Initiates discharge planning by assessing client/patient and family needs, identifying non-medical psychosocial needs and post-discharge medical needs, and informs patient and family of discharge planning options.
  • Data Analysis: Collects data on variances from screening criteria, performs data analysis to proactively identify opportunities to improve processes and promote leading practices.

Requirements

  • Valid License: Valid New York State license and current registration to practice as a Registered Professional Nurse issued by the New York State Education Department (NYSED).
  • Baccalaureate Degree: Baccalaureate degree in Nursing or related health field from an accredited college or university.
  • Certifications: Holds, or obtains through facility orientation, a valid and current certification in Basic Life Support (BLS) through the American Heart Association (AHA).
  • Experience: Two (2) years of experience as a Registered Professional Nurse.

Benefits

NYC Health Hospitals offers a competitive benefits package that includes:

  • Comprehensive Health Benefits: Comprehensive health benefits for employees hired to work 20+ hours per week.
  • Retirement Savings and Pension Plans: Retirement savings and pension plans for eligible employees.
  • Loan Forgiveness Programs: Loan forgiveness programs for eligible employees.
  • Paid Holidays and Vacation: Paid holidays and vacation in accordance with employees' collectively bargained contracts.
  • College Tuition Discounts: College tuition discounts for eligible employees.
  • Professional Development Opportunities: Professional development opportunities for all employees.
  • Multiple Employee Discounts: Multiple employee discounts programs for all employees.

Estimated Salary: $85,000 - $115,000 per year, depending on experience.

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