The Visiting Nurse Service of New York (VNSNY) is the nation's largest not-for-profit home- and community-based health care organization, serving the five boroughs of New York City, and Nassau, Suffolk, and Westchester Counties. For 125 years, VNSNY has been committed to meeting the health care needs of New Yorkers with compassionate, high-quality home health care. We offer a wide range of services, programs, and health plans to meet the diverse needs of our patients, members, and clients from before birth to the end of life.
Each day, more than 13,000 VNSNY employees- including nurses, rehabilitation therapists, social workers, other allied professionals, and paraprofessionals- deliver compassionate care, unparalleled medical expertise, and 24/7 solutions and resources to more than 48,000 patients and members, helping them to live the best lives possible in their homes and communities.
Oversees and directs clinical utilization, authorization, and care management for field staff and/or managed care organizations to ensure effective utilization and care management as defined by inter professional best practices. Ensures clear and appropriate visit utilization using evidence-based practices to provide positive clinical outcomes and efficient use of resources. Identifies and addresses inter-professional performance issues related to utilization management among staff and provides individualized performance evaluation assessments to clinical leadership and staff. Utilizes evidence based practices to care manage individuals to prevent hospitalization occurrences. Manages relationships with individuals in order to prevent untoward outcomes. Manages clinical and financial risk of value based contracts. Works under general supervision.
Licensure: License and current registration to practice as a Registered Professional Nurse in NYS required.
Education: Bachelor&rsquot;s or Master&rsquot;s Degree in Nursing required.
Certification: Population Care Coordination certification required within one year of job entry date. Care Management, Case Management, OASIS or other applicable certification preferred.
Experience: Minimum two years&rsquot; experience as a registered nurse required. Utilization management managed care experience preferred/care management. Proficiency in Microsoft Office applications required. Demonstrated analytical skills required.