JOB PURPOSE:

The Clinical Assessment Outreach Manager is accountable for educating referral sources and prospects about CenterLight’s Program of All-Inclusive Care for the Elderly (PACE), including services offered and Medicare and Medicaid eligibility. This position is tasked with conducting outreach and effectively guiding prospects through the onboarding process and growth of the company. This person will conduct clinical assessments utilizing the Uniform Assessment System of New York (UAS-NY) and will document clinical and other enrollment information in the electronic record system. This position is also responsible for helping develop efficient and effective systems that ensure quality care and compliance with state, PACE, and organizational regulatory requirements.

JOB RESPONSIBILITIES:

• Meet referral and enrollment goals set forth by management by building relationships with referral partners to create engagement opportunities with prospective enrollees and their caregivers.

• Ensure high performance and productivity of pre-enrollment verifications of Medicare, Medicaid, and PACE eligibility.

• Educate referral sources, prospective participants/caregivers, and other audiences on relevant PACE program benefits as well as CenterLight’s initiatives and projects. Identify differentiators from other healthcare options and isolate key value propositions in relation to audience group and specific needs.

• Provide program education through lectures, presentations, events, meetings or other necessary communications with community and business stakeholders to facilitate PACE referral generation.

• Work with the Events Supervisor in identifying appropriate events, community partners or other resources and opportunities to educate the community about CenterLight PACE and provide education / technical / administrative support for planning and execution.

• Maintain knowledge of all applicable CMS, DOH and PACE-specific guidelines, including organizational and departmental policies and procedures. Ensure familiarity with & compliance, amongst staff, with state & federal laws regarding Medicaid and Medicare Eligibility and Enrollment regulations.

• Directly assist intake activities as necessary, including general qualification screening, documentation collection, benefit education/applications, site tours, home visits, and other follow-up to aid in the enrollment or education of a prospect.

• Work closely with the Intake Navigators and Account Managers to schedule in-home or virtual pre-enrollment assessment appointments with prospective participants.

• Conduct pre-enrollment assessments using the UAS to determine eligibility of the prospective participant and confirm if they require greater than 120 days of Community Based Long Term Care Long Term Care (CBLTC) Services.

• Complete the Tasking Tool to determine appropriate home assistance with ADLs/IADLs combined with attendance at the CenterLight PACE site.

• Document all interactions and outcomes in the designated clinical management/electronic record system.

• Work with the quality review team to ensure accuracy and completeness of all necessary documentation in the Health Commerce System and in the electronic record system.

• Work with the participant and/or their family/caregiver to develop the 30-day service plan and obtain enrollment agreement documentation during home visit or other setting agreed upon with prospect.

• Assist with administrative functions of the program, including but not limited to, putting together informational handouts/packets from approved marketing materials, following up on referrals and appointments, regular tracking and reporting of daily activities and compiling statistical data and reports.

• Work collaboratively with the Compliance and the Marketing departments in developing necessary outreach and intake operations related materials.

• Advise on operational process improvements that may positively impact enrollment turnaround, scheduling logistics, expense/financial-related efficiencies, engagement strategies, reporting and other critical touchpoints.

• Regularly review key performance metrics and analytics to improve process flows and/or quality of work.

• Interview, hire, train, supervise, progressively discipline, and counsel all staff in the department. Support new staff with onboarding to ensure supportive, collaborative, and efficient transition to the Business Development and Clinical Intake Teams.

• Meet goals set forth by the company and pivot when necessary.

• Develop workflows and staffing deployments in anticipation of new service areas.

• Only act within the scope of the individual’s authority to practice.

• Meet a standardized set of competencies for the specific position description established by the PACE organization before working independently.

• All other duties as assigned.

Schedule: 8:30AM – 5:30PM

Weekly Hours: 40

QUALIFICATIONS:

Education: BS in Nursing or other health-related area, preferred.

Experience:

• 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 PACE 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 PACE 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.

License: Active and unrestricted New York State RN license.

Additional Requirements:

• Be legally authorized (for example, currently licensed, registered, or certified if applicable) to practice in the State in which the healthcare professional will perform the function.

• 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.

Language: Bilingual, preferred.

Physical Requirements

Individuals must be able to sustain certain physical requirements essential to the job. This includes, but is not limited to:

• Standing – Duration of up to 6 hours a day.

• Sitting/Stationary positions – Sedentary position in duration of up to 6-8 hours a day for consecutive hours/periods.

• Lifting/Push/Pull – Up to 50 pounds of equipment, baggage, supplies, and ability to lift patients safely and using OSHA guidelines, etc.

• Bending/Squatting – Must be able to safely bend or squat to care for patients, use medical supplies, etc.

• Stairs/Steps/Walking/Climbing – Must be able to safely maneuver stairs, climb up/down, and walk to access work areas Position requires the individual to be able to travel, and walk between sites/locations and work areas throughout the day.

• Agility/Fine Motor Skills - Must demonstrate agility and fine motor skills to operate and activate equipment, devices, instruments, and tools (ie. typing, use of medical supplies, equipment, etc.)

• Sight/Visual Requirements – Must be able to visually assess patients, read orders type/write documentation, etc. with accuracy.

• Audio Hearing and Motor Skills (language) Requirements – Must be able to listen attentively and document information from patients, community members, providers, etc., and intake information through audio processing with accuracy. In addition, must be able to speak comfortably and clearly with language motor skills for customers to understand the individual.

• Cognitive Ability – Must be able to demonstrate good decision-making, reasonableness, cognitive ability, rational processing, and analysis to satisfy essential functions of the job.

  We are an affirmative action and equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, height, weight, or genetic information. We are committed to providing access, equal opportunity, and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities.

Salary Range (Min-Max):$115,000.00 - $120,000.00

CenterLight Healthcare is one of the oldest non-profit comprehensive healthcare organizations in the United States. We are a premier provider of home and community-based healthcare and services in the New York metropolitan area, serving all five boroughs of New York City, as well as Westchester, Nassau and Suffolk Counties.

Through CenterLight TeamCare, we offer comprehensive healthcare and other services that enrich the lives of our participants and let them live safely at home and in their communities. TeamCare, a program of CenterLight Healthcare, is the nation’s largest not-for-profit Program of All-Inclusive Care for the Elderly (PACE). Each day, our employees serve a richly diverse population of 3,300 participants, speaking 75 languages and dialects throughout our 14 facilities. Learn more at www.centerlightteamcare.org.

Need help creating an account? Contact CenterLight HR Helpline 347-640-6108.