Jobs
>
New York City

    Director of Long Term Care Clinical Programs - New York, United States - Metroplus Health Plan Inc

    Metroplus Health Plan Inc
    Metroplus Health Plan Inc New York, United States

    5 days ago

    Default job background
    Description
    Director of Long Term Care Clinical Programs

    Job Ref: 103085


    Category:
    Utilization Review and Case Management


    Department:

    MANAGED LONG TERM CARE
    Location: 50 Water Street, 7th Floor, New York, NY 10004


    Job Type:
    Regular


    Employment Type:
    Full-Time


    Hire In Rate:
    $155,000.00


    Salary Range:
    $155, $170,000.00

    Empower. Unite. Care.

    MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.

    About NYC Health + Hospitals


    MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc.

    As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth 's network includes over 27,000 primary care providers, specialists and participating clinics.

    For more than 30 years, MetroPlusHealth has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.

    Position Overview


    The Director of Long Term Care Clinical Programs (formerly MLTC Clinical Programs) is responsible for supporting the day-to-day functions of the MLTC, MAP, and Nursing Home Care Management team, ensuring staff are adhering to policies and procedures, and that members needs are being met.

    The Director of Long Term Care Clinical Programs will be responsible for ensuring staff are meeting their goals, and that the necessary training, coaching, development, and evaluation of employee performance occurs.

    Job Description


    • Oversee the Long Term Care Management team, comprised of a Manager, two Team Leads, and twentyone care managers for MLTC, MAP and nursing home members
    • Provide training and direction to support to Manager, Team Leads and Care Managers, ensuring they are effectively completing assigned responsibilities; managing caseloads, correctly interpreting regulations, policies, operational procedures, and objectives; reviewing operations in assigned area to ensure a high level of quality that is consistent with organizational standards
    • Participate in utilization review activities; perform case management analysis; and oversee concurrent review functions with appropriate follow-up action plan and intervention.
    • Participate in activities to monitor compliance with service authorization regulations, the effectiveness of care plans and service provision guidelines, and their impact on outcomes.
    • Provide feedback on the Care Management Team's care plans and service plan development process to ensure they are evidence-based and meeting professional standards, both clinically and in terms of documentation
    • Develop and implement on-going staff training related to Care Management and Utilization Management and ensure the appropriate tools are available for implementation of policies and procedures, documentation in MetroPlusHealth's member record, and monitoring and reporting
    • Facilitate requests from members for change in the care manager
    • Identify areas for improvement of existing operational policies and procedures, develop recommendations to department senior management, and follow through with the implementation through continued monitoring
    • In conjunction with the Senior Director and other departmental managers, manage staff hiring, work allocation and scheduling, training and professional development, performance management, and related management activities
    • Develop standards of staff performance and oversight to ensure performance indicators and program requirements are being met.
    • Develop and initiate standards of performance, including communication with members, adherence to practice guidelines and care management protocols.
    • Ensure care management compliance with NYSDOH MLTC program requirements.
    • Support the annual revision of the MLTC and MAP Member Handbooks or more often based on regulatory changes and DOH notifications.
    • Prepare data and written reports or materials for meetings and as required or requested by leadership.
    • Actively participate in internal and external audits as needed.
    • Support departmental quality improvement activities to improve program performance.
    • Evaluate and assess staff on an on-going basis, offering oral and written counseling as deemed required.
    • Conduct departmental meetings and in-services associated with the implementation of new policies and procedures specific to MLTC, MAP and Medicaid Nursing Home members.
    • Perform other duties as directed and as necessary.
    Minimum Qualifications


    • Bachelor's Degree required. Advanced degree preferred.
    • A minimum of six years' experience in a MCO setting, preferably with MLTC, Special Needs/LTHHCP/CHHA or equivalent experience.
    • Minimum of three years managerial experience.
    • Knowledge of computers and healthcare information systems.
    • Ability to work in a fast-paced environments and technical clinical expertise required.
    Preferred Qualifications


    • Experience with geriatric population
    • Certification in Case Management
    • Knowledge and expertise of care management-based computer systems and Microsoft office products.
    • Experience with Medicaid recipients and community services
    • Experience in managed care and/or care management
    Licensure and/or Certification Required


    • Registered Nurse with a current licensure in NYS

    Professional Competencies:

    • Integrity and Trust
    • Customer Service Focus
    • Functional/Technical skills
    • Excellent communication, written and analytical skills.
    • Highly organized skills required.
    #LI-Hybrid
  • Mount Sinai

    Nurse Practitioner Clinical Program Manager

    2 days ago

    Mount Sinai New York, United States

    **Description** · The Per Diem Clinical Program Manager is responsible for overseeing staff, operations and resources within a department or division to ensure optimal result and high employee engagement. This individual ensures that the department is run according to institution ...

  • Mount Sinai Hospital

    clinical program manager

    1 week ago

    Mount Sinai Hospital New York, NY, United States

    Job Description · The Clinical Program Manager provides clinical support and administrative direction for the Early Phase Clinical Trials Unit (EPTU) group within the Tisch Cancer Institute's Clinical Trials Office (TCI CCTO). · In collaboration with the Executive Director, clini ...

  • Mount Sinai Medical Center

    Clinical Program Manager

    1 week ago

    Mount Sinai Medical Center New York, United States

    · The Clinical Program Manager provides clinical support and administrative direction for the Early Phase Clinical Trials Unit (EPTU) group within the Tisch Cancer Institute's Clinical Trials Office (TCI CCTO). · In collaboration with the Executive Director, clinical trials inve ...

  • Mount Sinai Medical Center

    Clinical Program Manager

    1 week ago

    Mount Sinai Medical Center New York, United States

    · The Clinical Program Manager is responsible for assuring compliance with mandated clinical orientation, competency assessment and interventions in the assigned clinical program of designated nursing staff within the Medical Center. This individual interfaces directly with MSMC ...

  • Mount Sinai Hospital

    clinical program manager

    1 week ago

    Mount Sinai Hospital New York, NY, United States

    Job Description · The Clinical Program Manager is responsible for assuring compliance with mandated clinical orientation, competency assessment and interventions in the assigned clinical program of designated nursing staff within the Medical Center. This individual interfaces dir ...

  • Mount Sinai Medical Center

    Clinical Program Manager

    6 days ago

    Mount Sinai Medical Center New York, United States Full time

    · The Clinical Program Manager, Clinical Command Center is a Registered Professional Nurse, Physician Assistant, or Nurse Practitioner, who manages the 24 hour a day functions of health-system throughput, transfer center, quality, and delivery of care. The Clinical Program Manag ...

  • Northwell Health

    Clinical Program Manager

    1 week ago

    Northwell Health New York, United States

    Job Description · Plans and implements clinical services, systems, and performance improvement activities as they relate to a multidisciplinary approach to providing care to patients. Collaborates with management in developing and maintaining policies and procedures for the depar ...

  • Mount Sinai Hospital

    Clinical Program Manager

    1 week ago

    Mount Sinai Hospital New York, United States

    Job Description · We are seeking a Clinical Program Manager (CPM) to join a team of investigators and advanced practitioners who are dedicated to delivering compassionate, expert, and comprehensive cancer care to patients and families who participate in clinical trials. · The CPM ...

  • Mount Sinai Hospital

    Clinical Program Manager,

    5 days ago

    Mount Sinai Hospital New York, United States Full time

    Job Description · The Clinical Program Manager for Admitting and Throughput is a Registered Professional Nurse who participates in the coordination of clinical programs and services for designated patient populations, collaborates with clinical teams to facilitate patient admissi ...

  • Mount Sinai Hospital

    Clinical Program Manager

    1 week ago

    Mount Sinai Hospital New York, United States Full time

    Job Description · Title: Clinical Program Manager (Nurse Practitioner)-Pulmonary-Mount Sinai Hospital-Full Time-DayThe Clinical Program Manager is responsible for assuring compliance with mandated clinical orientation, competency assessment and interventions in the assigned clini ...

  • Mount Sinai Hospital

    Clinical Program Manager,

    6 days ago

    Mount Sinai Hospital New York, United States Full time

    Job Description · The Clinical Program Manager, Clinical Command Center is a Registered Professional Nurse, Physician Assistant, or Nurse Practitioner, who manages the 24 hour a day functions of health-system throughput, transfer center, quality, and delivery of care. The Clinica ...

  • Mount Sinai Medical Center

    Clinical Program Manager,

    6 days ago

    Mount Sinai Medical Center New York, United States Full time

    · The Clinical Program Manager, Clinical Command Center is a Registered Professional Nurse, Physician Assistant, or Nurse Practitioner, who manages the 24 hour a day functions of health-system throughput, transfer center, quality, and delivery of care. The Clinical Program Manag ...

  • RCM Health Care Services

    Clinical Fellowship Program

    13 hours ago

    RCM Health Care Services New York, United States

    *Clinical Fellowship Program/CFY-SLP* · RCM Health Care Services is hiring CFs that can work in a pediatric setting in all 5 boroughs of NYC. Our pediatric settings consist of DOE Schools (public, private, and charter) as well as Therapy Clinics. We offer full-time, part-time, an ...

  • Mount Sinai Hospital

    Clinical Program Manager

    1 week ago

    Mount Sinai Hospital New York, United States Full time

    Job Description · The Clinical Program Manager, Clinical Command Center is a Registered Professional Nurse, Physician Assistant, or Nurse Practitioner, who manages the 24 hour a day functions of health-system throughput, transfer center, quality, and delivery of care. The Clinica ...

  • Mount Sinai Hospital

    Clinical Program Manager,

    1 week ago

    Mount Sinai Hospital New York, United States Full time

    Job Description · The Clinical Program Manager, Clinical Command Center is a Registered Professional Nurse, Physician Assistant, or Nurse Practitioner, who manages the 24 hour a day functions of health-system throughput, transfer center, quality, and delivery of care. The Clinica ...

  • Mount Sinai Hospital

    Clinical Program Manager

    1 week ago

    Mount Sinai Hospital New York, United States Full time

    Job Description · Job Title: Clinical Program Manager- Medicine -Mount Sinai Hospital-Full Time-Day - Grant Funded · The Clinical Program Manager is responsible for assuring compliance with mandated clinical orientation, competency assessment and interventions in the assigned cli ...

  • Mount Sinai Hospital

    Clinical Program Manager

    1 week ago

    Mount Sinai Hospital New York, United States Full time

    Job Description · Job Title: Clinical Program Manager - Pulmonary - Mount Sinai Hospital - Full Time - Day · The Clinical Program Manager is responsible for assuring compliance with mandated clinical orientation, competency assessment and interventions in the assigned clinical pr ...

  • Mount Sinai Medical Center

    Clinical Program Manager

    1 week ago

    Mount Sinai Medical Center New York, United States Full time

    · Title: Clinical Program Manager (Nurse Practitioner)-Pulmonary-Mount Sinai Hospital-Full Time-Day · * The Clinical Program Manager is responsible for assuring compliance with mandated clinical orientation, competency assessment and interventions in the assigned clinical progra ...

  • Mount Sinai Medical Center

    Clinical Program Manager

    1 week ago

    Mount Sinai Medical Center New York, United States Full time

    · Job Title: Clinical Program Manager - Pulmonary - Mount Sinai Hospital - Full Time - Day · The Clinical Program Manager is responsible for assuring compliance with mandated clinical orientation, competency assessment and interventions in the assigned clinical program of design ...

  • Mount Sinai Medical Center

    Clinical Program Manager

    1 week ago

    Mount Sinai Medical Center New York, United States Full time

    · Job Title: Clinical Program Manager- Medicine -Mount Sinai Hospital-Full Time-Day - Grant Funded · The Clinical Program Manager is responsible for assuring compliance with mandated clinical orientation, competency assessment and interventions in the assigned clinical program o ...