About This Role
The Associate Director of Nursing at NYC Health + Hospitals/Coler will leverage clinical expertise and managed care experience to oversee managed care contracts, ensuring effective care coordination and optimal financial performance.
Highlights
- Pay: $151,000 - $160,000/year
- Location: New York, NY
- Facility: NYC Health + Hospitals/Coler
- Department/Unit: CASE MANAGEMENT
- Schedule: Full-Time, Day (9:00 A.M - 5:00 P.M)
What You'll Do
- Support escalations to Central Corporate Managed Care regarding issues with MCOs.
- Facilitate seamless care coordination between facilities, MCOs, and other healthcare providers.
- Prepare for contract negotiations with MCOs in collaboration with the Central Office Managed Care Team.
- Monitor and evaluate facility performance against contractual obligations.
- Conduct and summarize concurrent and retrospective reviews of resident/patient care authorizations.
- Analyze and report on denial trends, identifying key issues and effectiveness of the appeals process.
- Implement quality improvement initiatives based on performance data and feedback from MCOs.
- Prepare comprehensive analyses of MCO payments, identifying trends and areas for improvement.
- Monitor contract performance, including payment accuracy and compliance with contract terms.
- Ensure all managed care contracts comply with state and federal regulations.
Requirements
Education
- Master's Degree in Nursing Administration or a related nursing discipline required; Bachelor's Degree in Nursing also acceptable.
Experience
- Three (3) years of satisfactory nursing experience, two (2) years in a responsible administrative or supervisory capacity required.
Licenses & Certifications
- Valid New York State license and current registration to practice as a Registered Professional Nurse in New York State.
- Basic Life Support (BLS) may be required depending on assignment.
Benefits
- Comprehensive Health Benefits for employees hired to work 20+ hrs. per week
- Retirement Savings and Pension Plans
- Paid Holidays and Vacation
- Loan Forgiveness Programs for eligible employees
- College tuition discounts and professional development opportunities
- College Savings Program
- Union Benefits for eligible titles
- Multiple employee discounts programs
- Commuter Benefits Programs
About NYC Health and Hospitals
NYC Health + Hospitals is a leading healthcare provider committed to delivering exceptional patient care. They operate a network of facilities, including NYC Health + Hospitals/Coler, which is a certified 815-bed nursing facility with a 5-Star CMS Quality Rating.