Inpatient Care Manager at Capital District Physicians Health Plan Inc in Albany, New York

Job Description:

CDPHP and its family of companies are mission-driven organizations that support the health and well-being of our customers and the communities we are proud to serve. CDPHP was founded in Albany in 1984 as a physician-guided not-for-profit, and currently offers health plans in 29 counties in New York state. The company values integrity, diversity, and innovation, and its corporate culture supports those values wholeheartedly. At CDPHP, the employees have a voice and are encouraged to make an impact at both the company and community levels through engagement and volunteer opportunities. CDPHP invests in employees who share these values and invites you to be a part of that experience.

The Inpatient Care Manager (ICM) is responsible for assessing medical necessity of inpatient admissions, continued stay, and care coordination for CDPHP members across the continuum. The ICM will conduct telephonic as well as on-site utilization activities for both concurrent and retrospective inpatient stays. This may include face-to-face interaction with members as well as providers to assess discharge needs and assist with appropriate and safe discharge planning.

QUALIFICATIONS:

• Associates degree required. Bachelor's degree preferred.


• Registered Nurse with valid New York State license is required and registration renewed/maintained every 3 years.


• CCM preferred.


• A minimum of 2 years of recent acute care in a hospital setting required.


• A minimum one of (1) year quality/utilization review experience in health care setting preferred.


• Ability to review health care delivery against established criteria is required.


• Ability to anticipate member's needs through ongoing communication; with them, their families, hospital staff and CDPHP departments is required.


• Ability to document proficiently and accurately as required by regulatory bodies to meet standards.


• Demonstrate the ability to work as a team member; communicate effectively with internal and external customers and actively participate in discussions is required.


• Demonstrated problem solving skills, organizational skills, critical thinking skills, and proficient PC skills are required.


• Ability to travel locally. Access to reliable transportation to all CDPHP service areas to deliver service to members during regular business hours, evenings and possible weekends is required. Position requires someone who is flexible on a day to day basis to travel to facilities in the Capital District.


• Annual physical assessment will be required, as well as any other clinical requirements requested by the designated facility.

As an Equal Opportunity / Affirmative Action Employer, CDPHP will not discriminate in its employment practices due to an applicant's race, color, creed, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship, disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, protected veterans status, or any other characteristics protected under applicable law. To that end, all qualified applicants will receive consideration for employment without regard to any such protected status.

CDPHP and its family of companies include subsidiaries Acuitas Health LLC, Strategic Solutions Management Consultants (SSMC), Practice Support Solutions (PSS), and ConnectRX Services, LLC.
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