Spares Coordination Manager jobs in New York

Overview

Manages the day-to-day operations of the care coordination teams to ensure effective and quality service delivery and team/staff performance. This includes providing support for care management issues, problem resolution, complaint resolution and other service-related issues. Manages and coordinates the activities of the VNS Health Plans Care Coordination team to ensure member care coordination provided is consistent with Enterprise mission and strategic goals. Works under general supervision.

Responsibilities
* Manages the day-to-day operations of the Care Coordination service delivery and support staff. * Collaborates with Education department in coordinating/conducting new staff orientation, training and development. * Develops staff through individual/team coaching, internal and external resources/assignments. Involves staff in the process of self-development and holds staff accountable for meeting performance expectations/development plans. Uses a variety of methods in obtaining information about staff performance. * Ensures that all pertinent regulations, policies and guidelines are adhered to. Evaluates all pertinent policies, procedures and work processes; develops and implements improvement plans. * Manages and evaluates staff in delivery and coordination of comprehensive home and community-based long-term care services in accordance with standards of clinical practice, state and federal regulations and Enterprise policies and procedures; assures quality of services. * Reviews care management issues with interdisciplinary team, focusing on early identification and response to actual or potential quality issues or complaints and approvals requiring next level authorization. Attends interdisciplinary care team meetings when needed. * Provides case direction and assistance to Care Coordination staff when on-site intervention is required, ensuring quality and appropriate service delivery. * Monitors referral and enrollment processes to ensure timely and complete submissions, compliance with program requirements, and achievement of targets. Identifies areas of concern and recommends solutions as appropriate. * Participates in development and implementation of the Quality Assurance and Compliance initiatives and collaborates across team, regions and programs with VNS Health Plans management team. * Ensures that care coordination is provided by staff through a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet members' health needs. Communicates resources and services available to members through the continuum of care from enrollment to end of life care, including long term care services in the home, community and/or facility-based settings. * Participates in outreach activities to promote the program services; coordinates activities with Enterprise staff, outside community agencies and health care providers. * Ensures compliance with collective bargaining agreement; hears and, as appropriate, adjudicates first line grievances, as needed. * Investigates, analyzes and reports to Care Coordination leadership facts related to member complaints, case concerns, or challenging member issues including recommendations regarding interventions and responses. * Supports discharge planning staff to prepare for the safe and appropriate hospital discharge of complex cases. * Demonstrates competency as an expert of care management systems. * Provides input and recommendations for design and development of policies, processes and procedures for effective member case coordination, efficient department operations, and excellent customer service. * Ensures plans of care are aligned with CMS Triple Aim framework: improving the patient's experience of care (including quality and satisfaction), improving the health of populations, and reducing the per capita cost of healthcare. * Manages the promotion of consumer directed care as appropriate. * Collaborates with IT in the identification of new/revised system/technology needs. * Performs all duties inherent in a managerial role. Ensures effective staff training, evaluates staff performance, provides input for the development of the department budget, hires, promotes and terminates staff, and recommends salary actions, as appropriate. * Participates in special projects and performs other duties as assigned.
Qualifications
Licenses and Certifications:
License and current registration to practice as a Registered Professional Nurse in the state of New York required for RNs

Education:
Bachelor's Degree in Nursing required or Master's Degree in Social Work required

Work Experience:
Minimum five years of experience in home care, care management or related field required Minimum of two years progressive experience in clinical management required Demonstrated knowledge of NYS regulations regarding Medicare or Medicaid Managed Long Term Care health plans preferred Experience in managed care environment preferred Effective oral, written communication and interpersonal skills required