Professional, Hospital Based Care Manager

About the role

At MVP Health Care, we are on a mission to create a healthier future for everyone - which requires innovative thinking and continuous improvement. To achieve this, we are looking for a Hospital Care Manager to join #TeamMVP.

Responsibilities

• Utilize an integrated care management model that includes assessment, planning, implementation, care coordination, monitoring, and care planning to meet the comprehensive health needs of members admitted to selected hospital facilities.
• Collaborate with hospital discharge staff to identify the medical and psychosocial needs of members, function as a proactive partner, and provide appropriate education, resources, and healthcare coaching during the members' inpatient hospital stay.
• Engage with the member, their care giver (as appropriate), and their specific providers during the inpatient hospital stay.
• Identify potential barriers to a safe and effective discharge plan and provide guidance in understanding benefit coverage and navigating the health care delivery system.
• Work collaboratively with hospital staff and assist in discharge planning to ensure the member achieves optimal health care services through the coordination of quality, cost-effective care.
• Monitor and review cases with the appropriate provider and on-site clinical care teams to ensure appropriate outcomes when a significant concern is identified.
• Support members throughout their inpatient hospital stay and for a period of 30 days post-discharge to ensure adequate care coordination and education in the transition of care period.
• Contribute to our humble pursuit of excellence by performing various responsibilities that may arise, reflecting our collective goal of enhancing healthcare delivery and being the difference for the customer.

Requirements

• Current New York State Licensure as a Registered Nurse required with at least 4 years of recent clinical and Care Management experience.
• Certification in Case Manager (CCM) is required within 2 years of employment.
• Ability to work cross-functionally and influence clinical stakeholders to best support the patient's needs.
• Demonstrated clinical knowledge including an understanding of population health management and the care management process.
• Experience with situations that require strict adherence to confidentiality.
• Ability to make independent decisions regarding resource utilization and quality of care.
• Understanding of clinical and psychosocial issues that may alter treatment or care plan and good judgment when dealing with emotionally charged situations.
• Curiosity to foster innovation and pave the way for growth.
• Humility to play as a team.
• Commitment to being the difference for our customers in every interaction.

Skills

• Knowledge of Transition of Care (TOC)
• Knowledge of HEDIS & Quality Measure
• Knowledge of Government Programs

Benefits

MVP Health Care is committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting. MVP adheres to pay transparency nondiscrimination principles. Specific employment offers and associated compensation will be extended individually based on several factors, including but not limited to geographic location; relevant experience, education, and training; and the nature of and demand for the role.

Pay

$69,383.00-$92,279.00

Schedule

Not specified