Clinical Assessment Manager

What We Provide

• Referral bonus opportunities     
• Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays   
• Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability    
• Employer-matched retirement saving funds   
• Personal and financial wellness programs    
• Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care   
• Generous tuition reimbursement for qualifying degrees   
• Opportunities for professional growth and career advancement    
• Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities   

What You Will Do

• Conduct face-to-face or telehealth UAS-NY assessments according to state guidelines, policies, procedures, and protocols.
• Utilize clinical skills to assess and document all aspects of the potential members long-term community-based needs.
• Communicate with members, families, providers, and other parties as needed to complete an accurate comprehensive assessment.
• Utilizes VNS Health and state-approved assessment questionnaire, guidelines, and documentation as well as interviews with members, family, and care providers in decision-making.
• Performs in-home assessment for members who have identified significant changes in condition since last in-home assessment; provides comprehensive review and determination of member’s needs, including completion of UAS assessment questionnaire, tasking tool, and a projected service plan. Visits include all areas serviced by VNS Health Plans including upstate and downstate counties.
• Performs in-home assessment on members to determine the appropriate service plan, including completion of UAS assessment questionnaire, tasking tool, and a projected service plan. Visits include all areas serviced by VNS Health Plans.
• Explains VNS Health Plan benefits, including an explanation of the member's handbook.
• Ensures compliance with state and federal regulatory standards and VNS Health Plans policies and procedures.
• Identifies opportunities for alternative care options and contributes to the development of a safe member centered service plan
• Consult with supervisor and others in overcoming barriers in meeting goals and objectives.
• Maintains current knowledge of organizational or state-wide trends that affect member eligibility.
• Coordinates with other departments, e.g. Care Management, Legal Affairs, Grievance and Appeals, Compliance, Membership Eligibility Unit, Quality as needed.
• Participates in requests for out-of-network services when a member receives services outside of VNS Health Plans network services.
• Keeps current with all health plan changes and updates through on-going training, coaching and educational materials.
• Participates in special projects and performs other duties as assigned.

Licenses and Certifications:
Current license to practice as a Registered Professional Nurse in New York State requiredCertified Case Manager preferred

Education:
Bachelor's Degree in nursing or equivalent work experience requiredMaster's Degree in nursing or equivalent work experience preferred

Work Experience:
Minimum two years of clinical assessment, homecare or hospital experience requiredExcellent organizational and time management skills, interpersonal skills, verbal and written communication skills requiredDemonstrated strong relationship management skills, including a high degree of psychological sophistication and non-aggressive assertiveness requiredDemonstrated successful conflict management skills and negotiation of “win-win” solutions requiredWorking knowledge of Microsoft Excel, Power-Point, and Word requiredKnowledge of Medicaid and/or Medicare regulations requiredWorking Knowledge of UAS-NY preferred