Title- RN Clinical Assessment Outreach Manager
Location-New York, NY
Pay-$115,000-$120,000
JOB RESPONSIBILITIES:
- Achieve referral and enrollment targets by cultivating relationships with referral partners and engaging prospective enrollees and their caregivers.
- Verify Medicare, Medicaid, eligibility efficiently to maintain high productivity.
- Educate referral sources, potential participants, and caregivers on the benefits of the program and initiatives, highlighting key differentiators and value propositions tailored to their needs.
- Deliver program education through presentations, events, and meetings with community stakeholders to generate referrals.
- Collaborate with the Events Supervisor to identify suitable events and community partners for promoting, providing necessary support for planning and execution.
- Maintain knowledge of CMS, DOH, and guidelines, ensuring compliance with Medicaid and Medicare regulations among staff.
- Assist with intake activities such as qualification screening, documentation collection, benefit education, and home visits to facilitate enrollment.
- Coordinate pre-enrollment assessments with Intake Navigators and Account Managers, utilizing UAS to determine participant eligibility.
- Document all interactions and outcomes accurately in the electronic record system, ensuring completeness and compliance.
- Work with the quality review team to verify documentation accuracy in the Health Commerce System.
- Collaborate with participants and caregivers to develop service plans and secure enrollment agreement documentation.
- Support program administration by preparing informational materials, following up on referrals, and compiling statistical reports.
- Partner with Compliance and Marketing departments to develop outreach and intake materials.
- Recommend operational improvements to enhance enrollment efficiency, scheduling, engagement strategies, and reporting.
- Analyze performance metrics to optimize workflows and quality of services.
- Supervise department staff, including hiring, training, and providing ongoing support for professional development.
- Adapt strategies to meet company goals and respond to changing needs.
- Prepare workflows and staffing plans for expanding service areas.
- Adhere to authorized practices and meet competency standards set by the organization.
- Fulfill other duties as assigned.
REQUIREMENTS:
- Active and Unrestricted New York State RN License
- Minimum of one (1) year of experience working with a frail or elderly population or, if the individual has less than one (1) year of experience but meets all other requirements, must receive appropriate training from the organization on working with a frail or elderly population upon hiring.
- Three to five (3-5) years of experience in geriatrics, home care, MLTC, MAP, D-SNP and/or long-term care products.
- Knowledge of community-based long-term care services to dual eligible and frail adult population.
- Comprehensive understanding of federal and state regulatory requirements with respect to health care eligibility, coverage and services of various public programs.
- Familiarity with the Uniform Assessment System of New York (UAS-NY).
- Experience in working independently without significant oversight and/or direction from a supervisor.
- Be medically cleared for communicable diseases and have all immunizations up-to-date before engaging in direct participant contact.
- Excellent interpersonal skills, along with demonstrated ability to handle situations requiring immediate and urgent attention, while meeting targets and projections and performing daily tasks.
- Highly organized and flexible to meet submission deadlines.
- Provide excellent customer service and communication with referral sources, prospects and departments.
- Excellent written and oral communication skills, familiar with medical terminology.
- Computer Proficiency required in word, excel and statistical analysis and reporting.
- Preferred experience with Care Compass.
Job Type: Full-time
Pay: $115,000.00 - $120,000.00 per year
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Medical specialties:
Standard shift:
Weekly schedule:
- Monday to Friday
- Weekends as needed
Ability to Relocate:
- New York, NY: Relocate before starting work (Required)
Work Location: In person