Clinical Nurse Specialist in Depew, NY

Salary Range: $88,000.00 - $94,000.00 per year

$5,000 Sign-On Bonus: The Clinical Nurse Specialist has a key role in assessing the member’s care needs, prioritizing their care and initiates treatment or a treatment plan to ensure they receive immediate attention.
This is done in collaboration with the case owner.

TASKS:
• Responsible to contact members via phone or in person when acuity is identified to triage clinical need which may precipitate a visit by accurately assessing symptoms based on subjective and objective findings.
• Assist with completing RPM triage calls related to RPM alerts.
• May serve as a witness for goals of care discussions and MOLST completion.
• May be required to perform an in person visit based on acuity identified. Each on site visit note must include subjective data gathered from member, physical exam and plan.
• Serve as a liaison between members of the ICT by assessing members’ needs and communicating health information.
• Maintain accurate documentation of triage assessments and decisions.
• Assist with company initiatives to avoid unnecessary hospital re-admissions by communicating with the appropriate parties to ensure proper follow-up within specified time frames.
• Provide education and instructions for follow-up care and provide information to members and/or their responsible party regarding the current plan of care.
• Complete visits and documentation in the appropriate clinical platform, as per company guidelines.
• May assist with home diversions to Subacute Rehab process as needed.
• May complete a visit in the Subacute setting and complete a visit note.
• May participate in discharge planning for members admitted to or subacute setting.
• Coordinate and facilitate the member’s access to services with other health care providers including mental health providers as needed.
• Identify the potential need for additional medical services such as homecare or medical office visits. If appropriate collaborate with the primary care provider or specialists to facilitate appropriate referrals.
• May assist with scheduling appointments or referrals for members.
• May assist with completion of HRA per regulations and FC policies.
• Oversight of Transitional Care Management across all SNP programs.
• Receiving and documenting Transitions of Care for SNP Members: Inpatient, ER, Observation, and all planned and unplanned transitions in EHR or Care

Management Record.
• Actively communicate with network partners regarding transitions.
• Ensure that all stakeholders (PCP, APP, SW, RN, CC) are aware of the transition with timely notification via phone, EHR or E-mail as appropriate.
• Communicate with member’s social worker and/or care manager to ensure that the member’s HCP and/or family member, as specified in the EHR, is aware of the transition of care.
• In the event of a planned Transition of Care Setting (SNF to hospital for scheduled procedure, admission of SNP member from community to SNF for rehabilitation), all notifications are done in advance as is practicable.
• May advise health plan of prolonged or clinically intensive hospitalization per policy.
• May assist with utilization management, conduct utilization reviews for Levels of Care and provide determination.
• May assist Care Managers (SW) or RNs or Care Coordinators with ICP development and compliance.
• May provide weekend RN on call coverage in a rotation with other RN’s.
• Prepare quality review of transitions of members within assigned team in preparation for ISNP and CSNP IDT meeting or at request of management.
• Reviews and signs Individualized Care Plan (ICP).
• Other duties as assigned.

EDUCATION: RN licensed in New York State, Bachelor’s degree preferred
EXPERIENCE/ ABILITIES:
• Minimum of 3 years’ experience, preferably in or related to emergency care/Care or Case Management/Discharge Planning.
• Excellent written, verbal, and listening communication abilities.
• Must be able to build and maintain collaborative, cooperative, and productive relationships both over the phone and face to face with all internal and external customers including members and their families, physicians, the health plan, vendors, and other health care providers as well as any other stakeholders in the community.
• Must be able to make assessments of individuals who suffer from multiple co-morbidities on an independent and regular basis both over the phone and face to face in the member’s home to determine their immediate need.
• Must be flexible and supportive of team members whether assigned work is telephonic or in the field.
• Computer skills necessary: email, electronic medical record management, Word, and Excel.
• Ability to meet and maintain necessary requirements per facility guidelines based on job assignment. These requirements may be outside the scope of Family
Choice policies.

Benefits: 401(k), 401(k) matching, Employee assistance program, Flexible spending account, Health insurance, Dental insurance, Life insurance, Paid time off, Referral program

To apply, please email via Quick Apply