Job Title: Clinical Assessment Manager

Job Description

This position will ensure the effective and efficient completion of tasks associated with the clinical assessment process, including but not limited to clinical onboarding and reassessment, UAS-NY completion, comprehensive assessment, medication review, and post-hospital discharge evaluation. The Clinical Assessment Manager will follow all Department of Health policies and regulations pertaining to the Uniform Assessment System of New York (UAS-NY) as well as intake workflows related to accurate and timely completion of UAS assessments. The Clinical Assessment Manager serves as a valuable resource to the Intake, Enrollment, and Care Delivery teams by documenting critical clinical enrollment, evaluation, and documentation of correct diagnosis, reassessment, and change in condition information in the electronic record system.

Responsibilities

• Work closely with intake, enrollment, and care delivery teams regarding in-home or virtual assessment appointments with prospective or enrolled participants using the Uniform Assessment System of New York (UAS-NY).
• Conduct in-home assessments for PACE participants utilizing the UAS-NY to determine initial or continued plan eligibility by the requirement need of Community Based Long Term Care (CBLTC) Services for greater than 120 days, and care needs.
• Evaluate and review previous assessments (of all types) to ensure documentation of any/all changes are accurately reflected in EMR. Must include narrative comments and supporting documentation and escalate issues of significant changes to Care Delivery to provide corrected resources.
• Evaluate and review previous primary diagnosis and medications at key intervals to ensure updated documentation is accurately reflected in EMR and match the diagnosis entered into UAS. Update and/or modify diagnosis codes and medication updates and ensure the accuracy of information. Must include narrative comments and supporting documentation and escalate issues of changes to ensure proper care and management of cases are followed.
• Promote and educate potential referral sources about the PACE program as needed to encourage participation in the program through presentations, lectures, meetings, or other support.
• Educate potential/new PACE participants on plan benefits, services, and care delivery model.
• Escalate questions or concerns during the assessment to the quality review team to ensure appropriate completion of UAS-NY and handling of on-site issues that may require intervention.
• Complete and/or reassess previous PCAT Tasking Tool to determine appropriate home assistance with ADLs/IADLs combined with attendance at the PACE site.

Essential Skills

• Current active and unrestricted license in NYS as a Registered Nurse.
• Legally authorized to practice in the State in which the healthcare professional will perform the function.
• Medically cleared for communicable diseases and up-to-date immunizations before engaging in direct participant contact.
• Positive attitude and outlook with the ability to multi-task in a constantly changing environment.
• Flexibility to work weekends to meet deadlines.
• Highly motivated and self-driven individual with a willingness to work within a strict deadline environment.
• Proficiency in Microsoft Office products, report development, and strong writing skills.
• Excellent communication and interpersonal skills.
• Customer Service oriented with strong clinical management skills.
• Minimum of one (1) year of experience working with a frail or elderly population or appropriate training from the PACE organization upon hiring.
• Three to five (3-5) years in MLTC, LTHHCP, MAP, PACE, or other managed care programs.
• Experience working independently without significant oversight or direction from a supervisor.
• Minimum of five (5 ) years of experience in care/case management, disease management, population health management, utilization review, quality assurance, or discharge planning (preferably within a managed care, home care, or community health setting).
• Experience in utilizing and analyzing UAS-NY and Lenavi.
• Experience with Customer Relationship Management platforms and clinical management systems.

Additional Skills & Qualifications

• Strong clinical management skills.

Work Environment

The work environment includes a schedule of 8:30 AM – 5:30 PM with a total of 40 weekly hours. The role requires flexibility to work weekends to meet deadlines. The position involves both in-home and virtual assessments, necessitating a professional demeanor and the ability to adapt to changing environments. The candidate should be comfortable working independently and as part of a team.

Pay and Benefits

The pay range for this position is $110000.00 - $115000.00/yr.

Benefits:
Medical/Dental/Vison insurance through United Healthcare
403(b) retirement plan with employer match
Commuter transit and parking plans
FSA
DCA
HRA
HSA
EAP
Discretionary PTO

Workplace Type

This is a fully onsite position in White Plains,NY.

Application Deadline

This position is anticipated to close on Mar 22, 2025.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

Diversity, Equity & Inclusion

At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:

• Hiring diverse talent
• Maintaining an inclusive environment through persistent self-reflection
• Building a culture of care, engagement, and recognition with clear outcomes
• Ensuring growth opportunities for our people

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.

Salary : $110,000 - $115,000