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Senior Admissions Nurse Liaison
2 months ago
NYC Health + Hospitals/Gouverneur is a 295-bed Skilled Nursing Facility (SNF) with a 5-Star CMS Quality Rating located in Manhattan's Lower East Side neighborhood.
We offer enhanced, cutting-edge healthcare services in a state-of-the-art space, providing 24-hour care for individuals in need of sub-acute care, long-term care, or hospice care, including services like physical therapy, occupational therapy, speech, and vocational rehabilitation.
Gouverneur is an academic affiliate of NYU School of Medicine and Rusk Institute of Rehabilitation Medicine.
We are proud to be ranked #7 in Newsweek's Best Nursing Homes in New York 2024 and have received high-performance ratings for Long-term Care and Short-term Rehabilitation from U.S. News & World Report's Best Nursing Homes in America 2024.
Job Summary:Under the direction of the Director of Admissions, the Senior Admissions Nurse Liaison oversees admission clinical activities for 5 Skilled Nursing facilities.
Directly responsible for oversight and management of the admissions nurse liaisons, within the framework of established policies and procedures governed by the New York State Department of Health.
Provides direction and leadership to admissions department in absence of director and associate director.
Provides clinical guidance to director and admitting staff in relation to patient/resident admissions, transfers, and discharges throughout the Post-Acute Care Service Line.
Key Responsibilities:- Oversees the admissions clinical activities of admission nurse liaison for their assigned facility in accordance with resident needs, government regulations, and established policies to maintain quality care for the residents while achieving the facility's business objectives.
- Ensures admission nurse liaisons perform high-quality reviews of referrals.
- Ensures quick turnaround of referral response.
- Reviews and summarizes denial reasons of referrals monthly.
- Monthly audits and summarizes the levels of care authorized by managed plans and the levels recommended by admission nurse liaison.
- Monthly evaluates appropriateness of recommendations of level of care by admission nurse liaison for managed care referrals.
- Trains and ensures clinical review competencies of admission nurse liaison.
- Is the point of contact for escalated clinical concerns involving referrals for SNF/NH admissions.
- Participates in preparation for regulatory agency audits and surveys; responds to information inquiries as required.
- Assists with developing and promoting marketing activities for including building referral source relationships to increase referral volumes.
- Assists with monitoring overall efficiencies of the Centralized Admissions Department including responding to referrals faster and more thoroughly.
- Negotiates rates with managed care companies based on medical and nursing needs.
- Participates in off-premises networking and recruitment for admission which include, but not limited to, visiting and communicating with other health care professionals.
- Maintains ongoing communication and a positive rapport with all referral sources.
- Communicates effectively with residents, families, and staff throughout the admissions process.
- Provides coverage with admission activities as required.
Responsibilities include responding electronically to Careport referrals, understanding health insurance coverage for patients, reviewing patients' medical records, providing clinical assessment of appropriateness for admission to SNF/NH and LTAC as needed, documenting decision to admit or not admit incorporating the use of industry clinical criteria, and ensuring compliance with needed referral information from referral sources to make a timely decision regarding admission and have at-hand for in-house physician inquiry.
Requirements:- Licensed and currently registered to practice as a Professional Nurse in New York State.
State, plus (2) or (3) below.
- A Master's Degree in Nursing Administration, Education, or an equivalent field and a minimum of six years of satisfactory nursing experience, of which four years shall have been in a supervisory, teaching, or administrative capacity; or,
- A Baccalaureate Degree in Nursing and seven years of satisfactory nursing experience, five years of which shall have been in a supervisory or teaching capacity; or,
- A satisfactory equivalent combination of education and experience. However, all candidates must be licensed and currently registered to practice as a Professional Nurse in New York State.
- Experience working in nursing capacity in long-term care setting with experience in an Admissions capacity preferred.
- Previous management experience preferred.
- Requires critical thinking skills, decisive judgment, and the ability to work with minimal supervision.
- Must be able to work in a fast-paced environment and take appropriate action.
- Strong communication skills, both oral and written.
- Proficiency in MS Office Suite (Outlook, Word, Excel, and PowerPoint).
- Ability to work in a collaborative, team-oriented environment.
- Knowledge of state and federal regulations related to nursing home admissions. Knowledge of Case Management/MDS regulations preferred.
