To directly guide a prospective Program of All-inclusive Care for the Elderly (PACE) participant through the clinical onboarding process leading to enrollment in CenterLight PACE. This position will ensure effective and efficient completion of tasks associated with the enrollment process; provide appropriate education about PACE to all relevant stakeholders; and to be a valuable resource to the Care Delivery Team by documenting critical clinical enrollment information in the electronic record system.
- Educates prospective PACE participants on plan benefits, services, and care delivery model.
- Assists with administrative functions of the program, including but not limited to, following up on referrals and appointments, as well as tracking and reporting of daily activities.
- Maintains knowledge of all applicable CMS/PACE guidelines and departmental policies and procedures.
- Works closely with intake operational team regarding in-home or virtual assessment appointments with prospective participants (utilizing the Uniform Assessment System of New York, UAS-NY). During this visit answers questions about the PACE program and emphasizes the unique benefits of the PACE program.
- Conducts the pre-enrollment UAS and determines eligibility of the prospective participant to require greater than 120 days of Community Based Long Term Care Long Term Care (CBLTC) Services.
- Works with quality review team to ensure accuracy and completeness of all necessary documentation in the Health Commerce System and in the electronic record system
- Completes the Tasking Tool to determine appropriate home assistance with ADLs/IADLs combined with attendance at the CenterLight PACE site.
- Develops the Service plan and obtains enrollment agreement documentation during home visit or other setting agreed upon with prospect.
- Complete 2-3 assessments per day (subject to change)
- Promotes and educates potential referral sources about the PACE program as needed to encourage participation in the program through presentations, lectures, meetings, or other support.
- Advises on operational process improvements that may positively impact enrollment turnaround, scheduling logistics, expense/financial-related efficiencies, engagement strategies, reporting and other critical touchpoints.
- Documents all interactions and outcomes in the designated clinical management/electronic record system
- Regularly reviews key performance metrics and analytics to improve process flows and/or quality of work.
- Supports new staff with onboarding to ensure supportive, collaborative, and efficient transition of new staff to the Clinical Intake Team
- Other tasks as required
- New York State RN license or Physician’s Assistant’s certification/license
- 3-5 years in MLTC, LTHHCP or other managed care program.
- Experience in working independently without significant oversight and or direction from a supervisor
- Willingness to travel throughout the greater NYC metropolitan region (80% of the time)
- Bilingual skills strongly preferred: Bengali, Korean, Chinese, Spanish
- Flexibility one weekend a month before submission deadline
- Highly motivated and self-driven individual with willingness to work within a strict deadline environment
- Excellent communication and interpersonal skills required
- Works inside at office locations and outside in varied weather conditions in all areas of the community, using private or public means of transportation
- Ability to sit/ stand for extended periods of time and ascend/descend stairs
Job Type: Full-time
Pay: $90,000.00 – $105,000.00 per year
- 401(k) matching
- Dental insurance
- Disability insurance
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Travel reimbursement
- Tuition reimbursement
- Vision insurance
- Home Health
- 8 hour shift
- What is your expected salary range?
- Is this location commutable?
- UAS: 1 year (Preferred)
- RN license (Preferred)
Work Location: One location
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