Healthcare risk manager jobs in Buffalo, New YorkCreate job alerts

Job Description GLIN IPA seeks a dedicated and proactive Care Manager Registered Nurse (RN) to join our multidisciplinary healthcare team on a Full-Time basis. In this role, the Care Manager RN will provide patient-centered coaching and care coordination in a primary care and telephonic setting, ensuring seamless navigation for patients with complex needs. The Care Manager RN will identify at-risk patients and collaborate with providers to develop and implement processes for preventative care, transitions of care, and chronic disease management. Using defined protocols and clinical expertise, the Care Manager RN will support patients following clinical events, address nursing care needs, and promote improved health outcomes. This role is essential in coordinating patient care, attributed to value-based contracts, and working closely with primary care providers and medical home teams to deliver high-quality, cost-effective care. Duties and Responsibilities (including but not limited to) • Evaluate patients for care management services, determine the appropriate level of care coordination management for the patient, • Complete a comprehensive assessment to identify patient risk and develop a care plan utilizing clinical expertise and judgment to evaluate the need for alternative services as needed, • Work collaboratively with physicians and in-house resources, including pharmacists, registered dieticians, social workers, and other disciplines, to create a person-centered care plan with measurable SMART goals, • Monitor and update the care plan to include progress toward achieving established goals and self-management activities, • Interact with patient, family and providers, and multidisciplinary care team to assess the options of care, including use of benefits and community resources to update the care plan. Utilize developed systems, processes, and initiatives to engage patients in relevant case management activities necessary to promote wellness and care at the right place and time., • Work collaboratively with physicians and in-house resources, including pharmacists, registered dieticians, social workers, and other disciplines, to support patient adherence to medical plan of care., • Supervise and act as a resource for non-clinical staff (i.e., care coordinators and social workers)., • Verify that appropriate home care, hospice care, and other ancillary services (DME, infusion services, etc.) are in place and are being delivered as directed by the care team, • Coordinate necessary referrals and authorizations within care management areas, • Facilitate the information flow between the hospital, long-term care, specialists and home health representatives and the care team, • Use available data and work with physicians and office staff to help identify high-risk, high-need, and potentially high-cost patients, • Coordinate care and communicate with multiple providers, internal and external to the practice., • Identify and utilize cultural and community resources and align with the patient’s cultural preferences as much as possible, • Ensure that members are screened for behavioral health issues, such as depression and substance abuse, and that they are receiving the necessary interventions and support., • Facilitate any necessary follow-up behavioral health needs with local behavioral health providers., • Attend required training and collaboration sessions [i.e., learning sessions, care management meetings, and practice team meetings] as scheduled., • Provide and facilitate open communication with physicians and office staff regarding patient status., • Obtain records from other physicians/labs/diagnostic centers as requested by the physicians and as needed for care coordination efforts., • Build collaborative relationships with the internal GLIN IPA population health team, participating providers, and community resources., • New York State Licensed RN, • Bachelor’s degree in nursing preferred; Associate degree in nursing is minimum requirement., • 2-3 years of experience in acute inpatient care, rehabilitation, sub-acute care, skilled nursing facilities, home care, ambulatory care management, or managed health plans., • Preferred: Certified Case Management (CCM) certification, • Principles of utilization management; care management principles; basic knowledge of health plan contracts and benefit eligibility requirements; Hospital structures, Managed Care and payment systems, • Timely and accurate documentation of day-to-day activities in designated technology platform, • Adaptable to new technologies and software, • Proficiency in EMR system(s), Outlook and data entry experience preferred, • Basic PC skills (MS Word/Outlook/PPT/Excel) We offer an outstanding benefits package including health, dental, 401K, vacation, PTO, and a great working environment. Pay range $80,000 to $93,000 annually The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job’s compensation range and determined by considering factors including, but not limited to, market data, education, experience, qualifications, and expertise of the individual, as well as internal equity considerations. Equal Employment Our culture encourages individual development, embraces an inclusive environment, rewards innovative excellence, and leads New York in provider and patient satisfaction. Great Lakes Integrated Network IPA (GLIN IPA) values diversity, inclusion, and equity as matters of fairness and effectiveness. We are committed to hiring and retaining a staff that reflects the diversity of the communities we serve, fostering an inclusive working environment where staff of all backgrounds feel welcomed and engaged. Great Lakes Integrated Network is an Equal Opportunity Employer

Job Description SUMMARY: Under indirect supervision and working interdependently with physicians, nurses, and other healthcare providers, provides a broad range of Physician Assistant services following established policies and protocols. DUTIES AND RESPONSIBILITIES: The following reflects management’s definition of essential functions for this job but does not restrict the tasks that may be assigned. Management may assign or reassign duties and responsibilities to this job at any time due to reasonable accommodation or other reasons. · Prescribes or administers specialized medical care to treat or prevent illness, disease, or injury. · Orders, performs, and interprets tests and analyzes records and examination information to diagnose patients' conditions. · Records and maintains patient information. · Monitors patients' conditions and progress and reevaluates treatments as necessary. · Explains procedures and discusses test results or prescribed treatments with patients. · Advises patients on diet, activity, hygiene, and disease prevention. · Refers patients to medical specialists or other practitioners when necessary. · Utilizes written guidelines/protocol for clinical decision-making and management. · Utilizes application of assessment, planning, implementation, and evaluation in formulating nursing diagnoses and interventions. · Prepares timely, legible, and complete documentation of all patient care as provided by law, regulation, and established policy · Demonstrates an awareness of and sensitivity to patient/family rights. · Applies safety principles as identified by established policy. · Participates in continuing education to continually improve skills and abilities and stay abreast of current technologies/practices. · Ensures compliance with legal issues including but not limited to patient confidentiality and risk management; ensures compliance with JCAHO, federal, state, and local regulations. · Participates in quality improvement and utilization review activities. · Exhibits a high degree of courtesy, tact, and poise when interacting with patients, families, and other healthcare professionals. · Adjusts to fluctuating peaks in patient flow, acuity, and other operational demands while maintaining quality. · Performs other duties as assigned by the manager. · Facilitate evaluation of records (chart reviews) by the physician’s peers, insurance companies, and other qualified health agencies. Ensure the quality and standard of records according to protocol, and also receive and implement constructive directives. · Review laboratory results and radiological modalities before they are filed into patient’s charts

Job Description SUMMARY: Assists with various healthcare services following established policies and protocols, including but not limited to obtaining specimens, conducting routine lab studies, and assisting with administrative functions. DUTIES AND RESPONSIBILITIES: The following reflects management’s definition of essential functions for this job but does not restrict the tasks that may be assigned. Management may delegate duties and responsibilities to this job at any time due to reasonable accommodation or other reasons. • Greets, receives, and prepares patients for appointments/procedures; conducts interviews with patients; measures vital signs and records information., • Performs routine laboratory/radiology tests on patients as established protocol provides., • Maintains nursing stations and examination areas in a manner consistent with OSHA standards and Universal Precautions procedures., • Maintains inventory of medical supplies and materials., • Receives and screens telephone calls, • Schedules patient appointments. (if necessary), • Coordinates patient flow., • Maintains office/department and patient records – filing and retrieving test results or charts., • Assists with patients medication refills (ONLY with the assistance of the Doctor/PA/NP/LPN), • Prepares timely, legible, and complete documentation of all patient care as provided by law, regulation, and established policy, • Prepares patient's forms for Doctors' approval, • Participates in continuing education to continually improve skills and abilities and stay abreast of current technologies/practices., • Applies safety principles as identified by established policy., • Ensures compliance with legal issues including but not limited to patient confidentiality and risk management; ensures compliance with JCAHO, federal, state, and local regulations., • Exhibits a high degree of courtesy, tact, and poise when interacting with patients, families, and other healthcare professionals., • Adjusts to fluctuating peaks in patient flow, acuity, and other operational demands while maintaining quality., • Performs other duties as assigned by the manager., • Participates in quality improvement activities