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Rochester Regional Health Senior Care Manager in Rochester, New York

Senior Care Manager

Rochester, New York

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  • Overview

  • Responsibilities

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Overview

At Rochester Regional Health, we know that delivering the best care means empowering nurses throughout every stage of their career. We’ve created a unique environment that fosters professional development and personal growth for our team members including a clinical ladder, competitive pay and benefits, and support for continuing education. It’s our way of investing in those who care.

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Responsibilities

Job IDREQ_119676FACILITYRochester General Hospital - Medical Office BuildingLOCATIONRochester, New York

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SUMMARY

The Sr. Care Manager is a member of Care Management working collaboratively with the multidisciplinary healthcare team to ensure the appropriate allocation of hospital resources while maintaining the quality of care. The Sr. Care Manager supervises the daily activities of their assigned team, working in collaboration within their peers and other members of the healthcare team. Provides oversight and direction on issues and collaborates with leader on the performance appraisal and counseling process. Actively participates in the utilization management process using standards of care to determine the most appropriate level of care. Highly involved in oversight of transitions of care. Participates in the development of plans for care and managing the care across the continuum to ensure a safe discharge in a timely manner.

STATUS:Full Time

LOCATION:Rochester General Hospital

DEPARTMENT:Care Management - Inpatient

SCHEDULE:Monday - Friday, Days

ATTRIBUTES

• Bachelor’s degree in Nursing required

•Registered Nurse with current New York State License

• Case Management Certification preferred.

• 5 – 7 years of acute hospital care, home care, care management, case management, or utilization management experience; to include a minimum of 1 year of experience in care management.

• Excellent oral and written communication and interpersonal skills

• Strong organizational and problem solving skills

• Good understanding of medical management techniques and processes

• Knowledge of federal and state regulations (DOH, Medicaid/Medicare)

• Knowledge of third party payor and/or managed care payment principles helpful

RESPONSIBILITIES

● Leads team in daily operational responsibilities

● Provides guidance and general oversight to less experienced employees; may train new team members.

● Serves as resource to others in resolution of complex issues, patient cases, etc.

● Using nationally recognized standards of care and guidelines, evaluates hospital admissions to assure care is medically necessary and delivered at the most appropriate level.

● Actively participates in the concurrent review process ad communicates and intervenes with third party payors to ensure reimbursement for services provided while maintaining the quality of care

● Collaborates with providers, patients, and families to address concerns and to identify safe effective discharge plans. Intervenes to facilitate early referral for discharge planning.

● Facilitates the discharge process by identifying and intervening with the health care team to identify alternative solutions to minimize system delays while ensuring a safe discharge plan.

● Coordinates and participates in the development, implementation and revision of evidence based clinical pathways and guidelines.

● Participates in driving clinical and administrative compliance with care guidelines and core measures. Identifies and recommends actions for improvement.

● Maintains accountability to hospital, state, and federal regulations, and professional standards. Initiates alternate level of care determinations in compliance with regulatory and contractual agreements.

● Actively participates in analysis of utilization and quality trends and makes recommendations to management on opportunities for improvement.

● Manages confidential information in accordance with ViaHealth policy and procedures.

● Oversees daily work activities and staffing of team members assuring all patient care units and provider service teams are covered.

● Assist in identification, development and implementation of medical management strategies and processes.

● Round on care management team to assist in complex case management, bringing forth identified issues to management.

● Participate in annual performance review process.

● Collaborates with physicians and chiefs of service to identify areas for improvement to drive physician satisfaction.

● Collaborates with multidisciplinary teams to minimize system delays and ensure safe discharge planning.

● Consistently plan on unexpected admissions and facilitate admissions.

● Address issues delaying patient discharges.

● Communicate clearly with Clinical Bed Coordination regarding all admissions, transfers, discharges.

● Assist Care Management staff in care to expedite flow and bed availability.

● Perform other duties as assigned.

Rochester General Health System is an Equal Opportunity / Affirmative Action Employer.Minority/Female/Disability/Veteran

LICENSES/CERTIFICATIONSBLS - Basic Life Support - American Heart Association (AHA); RN - Registered Nurse - New York State Education Department (NYSED)

Rochester Regional Health is an Equal Opportunity / Affirmative Action Employer. Minority/Female/Disability/Veteran

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Helping you succeed

Discover all the ways Rochester Regional Health supports your professional development and personal growth.

Clinical Ladder

Nurses who advance on our clinical ladder receive a promotion at the bedside through growth in their skillset, a new title and monetary recognition up to $3.00/hour

Rapid Pay Increases

Receive rapid pay increases every six months during the first two years of employment, and annual increases thereafter.

Unlimited Certifications

Nurses earn up to an additional $1.00/hour for each certification earned plus a $1,000 bonus for the first certification earned, and $500 for the second certification.

I began my healthcare career as a patient care technician while working towards my BSN. Rochester Regional Health offers a variety of opportunities for nurses, and leadership empowers us to fine-tune our interests and passions, while developing a strong clinical practice.

Megan Murphy, MSN, RN, BSNNurse Educator

I am very impressed with the focus and investment on education and professional development that’s being developed and implemented at RRH. Investing in staff is what distinguishes a good organization from a great one and I’m happy to see that RRH is working hard to distinguish itself as a great regional employer.

Benjamin C. Snyder, RN, BSNNurse Manager

Rochester Regional Health has been very supportive and inviting of any opportunities that I’ve wanted to explore. The opportunities for growth are truly unlimited. As the chair of the Clinical Ladder Committee, I’ve seen first-hand how many nurses take advantage of this and explore opportunities for their own growth and advancement.

Kaitlin Costello, RN, BSN, CEN, TCRNClinical Nurse Leader

Find Your Way

At Rochester Regional Health, empowering our nurses as they build their careers is our top priority. If you’re looking to make a change, learn more about how we can help you build a successful and fulfilling nursing career.

Based on your preferences and skill sets, you’ll have the opportunity to pursue the nursing career path that interests you most.

  • bedside nursing

  • clinical education

  • nursing leadership

  • operations

bedside nursing

Deepen your knowledge as a specialist within the expansive specialty unit that you are most passionate about, including:

  • Acute Medicine

  • Cardiology

  • Critical Care

  • Neuro/Stroke

  • Oncology

  • Pediatrics

  • Surgical

Kaitlin Costello, RN, BSN, CEN, TCRNClinical Nurse Leader

Clinical Education

Help others broaden their skills and proficiencies as a:

  • Preceptor

  • Clinical Nurse Specialist

  • Clinical Resource Nurse

  • Nurse Educator

Megan Murphy, MSN, RN, BSNNurse Educator

Nursing Leadership

Lead the way for other nurses with positions that include:

  • Charge Nurse

  • Clinical Nurse Leader

  • Nurse Manager

  • Nurse Director

  • Associate CNO

  • CNO

Kristen Oppet, RN, BS, MSHAVice President, Chief Nursing Officer

Operations

Take care of every person at every level by joining departments that require your expertise including:

  • Call Center

  • Care Management

  • Clinical Informatics

  • Infection Prevention

  • Nurse Recruitment (HR)

  • Patient Safety & Quality

  • Performance Improvement

  • Utilization Review

Chelsea E. Reff, MBA, RN-BC, BSNNurse Compensation Manager,

Rochester Regional Health

We are nurses growing together

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