Accountable Care Manager - New York, New York -

Permanent Nursing Job in
New York , New York, 10002

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NYC Health + Hospitals/Gouverneur provides primary and specialty outpatient care through its Diagnostic and Treatment Center (D&TC) and residential care for the elderly and infirmed in its 295-bed Skilled Nursing Facility (SNF).

Gouverneur provides a comprehensive array of on-site services, including primary care, pediatrics, women’s health, dentistry, behavioral health, podiatry, optometry, ENT, digital imaging, infectious disease, and other specialties and sub-specialties. NYC Health + Hospitals/Gouverneur Skilled Nursing Facility provides 24-hour care for individuals in need of short-term, long-term care or hospice care.

The facility is rated as a Best Nursing Home by US News and World Report. Post-Acute Care services include physical therapy, occupational therapy, speech and audiology, and vocational rehabilitation.

•Care coordination for WTC patients
•Work with patients and their treatment team to coordinate efficient and effective medical care, with an emphasis on pain control and symptom management and cancer treatment modalities referenced within the National Comprehensive cancer Network (NCCN)
•Help identify community and medical resources and assist healthcare team in any needed transitions in care
•Consult with social workers for financial and community resources as needed
•Provide information about palliative and hospice care to patient’s/significant others
•Address emotional and psychological concerns associated with cancer diagnosis, refer to WTC Mental Health providers when needed
•Clinical responsibilities will include care coordination in areas of medication reconciliation, advanced care planning, and transmission of transition records. Maintaining updated clinical progress and provider notes at periodic intervals, and performing periodic audits on care plan in alignment with NCCN guidelines for recommended monitoring and surveillance
•Telephonic aspect of case management will include calls to members on oral chemotherapeutic agents to assess for any adverse side effects, and facilitate with appropriate management of these side effects. Chronic pulmonary sarcoidosis and ILD calls will also evaluate disease stability/progression. RN Case manager will work with social worker and Pharmacy benefits manager to assure education on medication schedule and program coverage
•RN case manager will work with external case managers in the transition of patients back to in-house case management, as well as external transitions for Healthsmart case management when needed
•RN case manager will maintain in electronic system (example JIVA) authorizations for interventions/treatments that are approved or denied.
•RN case manager will coordinate services covered by WTCHP as well as maintain progress records.
•Treatment of WTC Patients
•Provide information and educational resources related to patient’s diagnosis and treatment when needed, such as smoking cessation programs and durable medical equipment use.
•Address emotional and psychological concerns associated with cancer diagnosis, refer to WTC Mental Health providers when needed
•RN case manager will have opportunity to do cancer screening assessment questionnaires with patients, and do Initial and Monitoring intake questionnaires with cancer and chronic pulmonary illness patients.
•RN case manager will work with patient and providers to manage co-morbid conditions, and maintain documentation on these interventions and member’s compliance with recommendations and clinic visits.

Job Requirements

1. Valid New York State license and current registration to practice as a Registered Professional Nurse issued by the New York State Education Department (NYSED); and
2. A Baccalaureate degree in Nursing or related health field from an accredited college or university; and
3. Two (2) years of experience as a Registered Professional Nurse.

4. Language(s) - Mandarin/Cantonese and/or Spanish.

5. Experience in oncology and/or case management/utilization review.


New York, New York , 10002

Employment Type



NYC Health + Hospitals

Date Posted

Jan 10th, 2019

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