JOB PURPOSE: The Director of Clinical Intake oversees all clinical activities involved in the Intake process for participants in the Program of All-Inclusive Care for the Elderly (PACE) and holds ultimate responsibility for evaluating and determining the clinical eligibility of prospective participants for enrollment. JOB RESPONSIBILITIES: + Lead efforts in continuous quality improvement to enhance staff performance and achieve optimal participant outcomes. + Oversee and approve the authorization of personal care hours in collaboration with the Care Delivery Department, ensuring alignment with participant needs and Medicaid regulations. + Work with the Market Engagement team to analyze referral trends, improve conversion rates of suitable candidates, and enhance the quality of enrollments. + Collaborate with Care Delivery leadership and team members to provide significant clinical information ahead of enrollment for a seamless transition and effective preparation for complex cases. + Partners with Care Delivery by meeting with site leadership and IDT to provide Intake updates, address concerns and improve overall process. + Serves as clinical point of contact for Care Delivery team regarding question, concerns or issues arising after enrollment. + Develop and analyze reports related to the clinical component of the Intake process to assess and improve enrollment quality. + Ensure Clinical Intake Managers and Intake Assessment Managers maintain accurate, timely, and appropriate documentation in compliance with departmental and governmental requirements. + Maintain expertise in Medicare and Medicaid regulations, providing relevant updates to staff and stakeholders as needed. + Engage in staff development by creating and delivering training materials and continuing education programs for team members. + Manages relationship with contracted agencies. Includes general oversight of day-to-day operations, providing supervisory oversight of agency contracted nurses, obtaining regular vendor staffing updates so required documents are supplied to HR, reconciling invoices to ensure accuracy and approving payment to vendor, participating in strategic meetings involving contractual agreements and working process + Develop and implement departmental policies, procedures, and workflows, presenting them to committees for approval. + All other duties as assigned Schedule: 8:30AM – 5:30PM Weekly Hours: 40 QUALIFICATIONS: Education: BS in Nursing or other health-related area preferred. Experience: + Minimum five (5+) years of experience in care/case management, disease management, population health management, utilization review, quality assurance or discharge planning (preferably within a managed care, home care or community health organization) + Minimum two (2+) years of experience in MLTC/Managed Care with preparation of Uniform Assessment System of New York (UAS-NY) + Proficiency utilizing and analyzing UAS-NY and eMedNY ePACES systems + Experience with Customer Relationship Management platforms and clinical management systems License: Registered Nurse with current license in the state of practice. Additional Requirements: + Positive attitude and outlook with the ability to multi-task in a constantly changing environment + Proficiency in Microsoft office products; report development and strong writing skills + Strong interpersonal skills + Customer Service oriented + Strong clinical management skills + Bilingual in Spanish, Chinese or Russian strongly preferred Physical Requirements Individuals must be able to sustain certain physical requirements essential to the job. This includes, but is not limited to: + Standing – Duration of up to 6 hours a day. + Sitting/Stationary positions – Sedentary position in duration of up to 6-8 hours a day for consecutive hours/periods. + Lifting/Push/Pull – Up to 50 pounds of equipment, baggage, supplies, and other items used in the scope of the job using OSHA guidelines, etc. + Bending/Squatting – Have to be able to safely bend or squat to perform the essential functions under the scope of the job. + Stairs/Steps/Walking/Climbing – Must be able to safely maneuver stairs, climb up/down, and walk to access work areas. + Agility/Fine Motor Skills - Must demonstrate agility and fine motor skills to operate and activate equipment, devices, instruments, and tools to complete essential job functions (ie. typing, use of supplies, equipment, etc.) + Sight/Visual Requirements – Must be able to visually read documentation, papers, orders, signs, etc., and type/write documentation, etc. with accuracy. + Audio Hearing and Motor Skills (language) Requirements – Must be able to listen attentively and document information from patients, community members, co-workers, clients, providers, etc., and intake information through audio processing with accuracy. In addition, they must be able to speak comfortably and clearly with language motor skills for customers to understand the individual. + Cognitive Ability – Must be able to demonstrate good decision-making, reasonableness, cognitive ability, rational processing, and analysis to satisfy essential functions of the job. Disclaimer: Responsibilities and tasks outlined in this job description are not exhaustive and may change as determined by the needs of the company. We are an affirmative action and equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, height, weight, or genetic information. We are committed to providing access, equal opportunity, and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. Salary Range (Min-Max):$160,000.00 - $165,000.00