Position Description:

The RPD is responsible for the regional delivery and supervision of care management services provided for enrollees within the Managed Long-Term Care Program (MLTC), in accordance with agency policy and procedures, and under the direction of the VP of Care Management. The RPD provides leadership and direction to the regional team ensuring that high quality, culturally sensitive and cost-effective services and benefits are provided. Hybrid position with work from home and some in office work as needed. Candidates must reside in New York State.

Performance Responsibilities and Standards:

• Responsible for the delivery of quality and safe patient care.
  • Accountable for quality of services, appropriate access and utilization, and cost control.
  • Ensure coordination and delivery of timely and safe member services.
  • Facilitate the flow of information and ideas between caregivers, families and members.
• • Review member records as indicated for quality and appropriateness of care and services.
  • Incorporate concepts of chronic care management in provision of services
  • Model and implement standards of professional practice.
  • Act as liaison between agency staff and outside services as needed.
  • Report and act on member or family complaints and grievances.
  • Investigate and report incidents of suspected client neglect and/or abuse.
  • Investigate and report incidents or accidents.
    
• Responsible for all duties inherent in a managerial role including the supervision of staff including assignment, staff development and evaluation.
  • Interview and hire staff in conjunction with Human Resources and VP of Care Management
  • Communicate with staff regularly and effectively both verbally and in writing.
  • Ensure adequate staffing and utilize staff appropriately for management and delivery of services.
  • Ensure staff adherence to documentation requirements and regulations.
  • Provide training to staff on an ongoing basis.
  • Evaluate staff performance in a timely manner, taking corrective action when necessary.
  • Monitor productivity and assist staff in reaching established organizational goals.
    
• Demonstrate knowledge of, and ensure compliance with, agency policies and procedures.
  • Assist in development of agency policies and procedures, and communicate policies to staff.
  • Understand and ensure compliance with agency policies, practices, and procedures.
  • Assist in development of job qualifications and job descriptions of staff.
  • Demonstrate knowledge and use of agency personnel policies and procedures.
  • Understand and support staff in billing and authorization requirements as they apply to the services and products provided.

• Demonstrate knowledge of, and ensure compliance with, federal, state, and local regulations governing home care and insurances.
  • Ensure staff compliance with federal, state, and local reimbursement requirements.
  • Demonstrate knowledge of quality improvement process, i.e., clinical record audit, utilization review, and risk management.
  • Interpret government regulations and guidelines as needed.
  • Fosters positive working relationships with regulatory entities and local governing bodies.
    
• Provide oversight, direction and leadership for sub-contract care management when applicable.
  
• Participates in outreach activities to promote plan growth.
  • Increase public awareness of the program through education, presentations, publications and marketing activities.
  • Develops and nurtures relationships with providers and increase understanding of the marketplace.
    
• Assume responsibility for personal growth and development as well as for staff.
  • Attend at least 2 in-services or continuing education programs per year to keep current in-home care.
  • Prepare and present staff development and community workshops.
  • Attend management meetings as scheduled.
  • Work cooperatively with staff, managers, and community resources.
  • Participate in agency or community committees.
  • Demonstrate knowledge of community needs and promote development of appropriate programs and services.

Job Qualifications:

Physical Requirements:

_____________________________________________________________________________________

About Nascentia Health:

Nascentia Health is leading the way in home care, post acute care and long-term community health. A healthcare system without walls, Nascentia is an innovator in the concept of healthcare, truly focused on the patient as a whole. By serving people in their homes, Nascentia Health is able to provide true holistic care. We can address immediate needs, help support positive long term medical and lifestyle choices that provide for better outcomes, leverage cutting edge in-home care technologies, and help avoid unnecessary visits to busy healthcare facilities.

Our employees are our greatest asset. They work hard every day to make our system amazing and are dedicated to our mission of being the premier home and community-based care system for the regions we serve. We want everyone to love what they do, be excited about coming to work, and take pride in being part of our team.

________________________________________________

Nascentia Health is an Equal Opportunity Employer (EOE)

Employment is contingent upon negative results of a pre-hire drug screen