Visiting Nurse Service Of New York Brooklyn , NY 11201
The Visiting Nurse Service of New York (VNSNY) is the nation's largest not-for-profit home- and community-based health care organization, serving the five boroughs of New York City, and Nassau, Suffolk, and Westchester Counties. For 125 years, VNSNY has been committed to meeting the health care needs of New Yorkers with compassionate, high-quality home health care. We offer a wide range of services, programs, and health plans to meet the diverse needs of our patients, members, and clients from before birth to the end of life.
Each day, more than 13,000 VNSNY employees- including nurses, rehabilitation therapists, social workers, other allied professionals, and paraprofessionals- deliver compassionate care, unparalleled medical expertise, and 24/7 solutions and resources to more than 48,000 patients and members, helping them to live the best lives possible in their homes and communities.
Leads the Inter-Disciplinary Team (IDT) which provides each member memberwith an individualized, comprehensive care plan designed to maximize and maintain individual's functional potential and quality of life. Authorizes and manages the clinical and customer service decisions relating to the case management and services provided to members.
Provides telephonic medical case management to members. Ensures all services provided are in compliance with VNSNY CHOICE policies and procedures as well as applicable state and federal regulations, while at the same time balancing clinical and customer service concerns. Works under general supervision.
Licensure: License and current registration to practice as a registered professional nurse in New York State required.
Education: Bachelor's Degree in Nursing (BSN) from an approved program preferred. Certification in Case Management preferred.
Experience: Minimum of two years of case management experience assessing needs, coordinating/collaborating services and referrals required.
Case management experience in a managed care organization or health plan preferred. Prior experience working with regulators, medical, behavioral health and social service providers and all levels of staff to care manage and coordinate services required. Familiarity with NY State assessment tools preferred.
Must have experience and qualifications reflective of needs of the dual eligible with long term care needs Population (i.e., communication, cognitive, or other barriers); and knowledge of physical health, aging and loss, appropriate support services in the community, frequently used medications and their potential negative side-effects, depression, challenging behaviors, Alzheimer's disease and other disease-related dementias, behavioral health and issues related to accessing and using durable medical equipment, as appropriate.Knowledge of Milliman criteria (MCG) preferred. Bilingual skills preferred.
Excellent organizational and time management skills, interpersonal skills, verbal and written communication skills required. Working knowledge of Microsoft Excel, Power-Point, and Word and strong typing skills required. Knowledge of Medicare/Medicaid and/or commercial regulations preferred.