Clinical Assessment Outreach Manager - MLTC - Brooklyn / Manhattan, NY - Tandym Group : Job Details

A health services network in New York City is currently seeking a Korean-speaking, licensed Registered Nurse (RN) to join their team as their new Clinical Assessment Outreach Manager. In this role, the Clinical Assessment Outreach Manager will be accountable for educating referral sources and prospects about the network's Program of All-Inclusive Care for the Elderly (PACE), including services offered and Medicare and Medicaid eligibility. About the Opportunity:

• Schedule: Monday to Friday
• Hours: 8:30am to 5:30pm
• Setting: Field

• 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 program benefits as well as initiatives and projects
• Provide program education through lectures, presentations, events, meetings or other necessary communications with community and business stakeholders to facilitate PACE referral generation
• 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
• Document all interactions and outcomes in the designated clinical management/electronic record system
• Perform other duties, as needed

• 1+ year of experience working with a Frail and/or Elderly population
• Bachelor's Degree in Nursing
• NYS Registered Nurse (RN) license

• 3+ years of experience in Geriatrics, Home Care, MLTC (Managed Long-Term Care), MAP (Medicare Advantage Plan), D-SNP (Dual Special Needs Plan), and/or PACE (Program of All-Inclusive Care for the Elderly) Long-Term Care products
• Familiarity with Community-based Long-Term Care services for dual-eligible and frail adult populations
• Knowledge of the Uniform Assessment System of New York (UAS-NY)