The Visiting Nurse Service of New York (VNSNY) is the nation's largest not-for-profit home- and community-based health care organization, serving the five boroughs of New York City, and Nassau, Suffolk, and Westchester Counties. For 125 years, VNSNY has been committed to meeting the health care needs of New Yorkers with compassionate, high-quality home health care. We offer a wide range of services, programs, and health plans to meet the diverse needs of our patients, members, and clients from before birth to the end of life.
Each day, more than 13,000 VNSNY employees - including nurses, rehabilitation therapists, social workers, other allied professionals, and paraprofessionals - deliver compassionate care, unparalleled medical expertise, and 24/7 solutions and resources to more than 48,000 patients and members, helping them to live the best lives possible in their homes and communities.
Oversees and directs clinical utilization/authorization for field staff and/or managed care organizations to ensure effective utilization/care and case rate management as defined by inter professional best practices. Ensures clear and appropriate visit utilization using evidence-based practices to provide positive clinical outcomes and efficient use of resources. Identifies and addresses inter-professional performance issues related to utilization management among staff and provides individualized performance evaluation assessments to clinical leadership and staff. Works under general supervision.
Partial remote schedule after comepletinga probationary period.
Licensure: Current registration to practice as a Licensed social worker in New York Stated required.
Certification: Care Management or Case Management certification required within one year of job entry date.
Education: Master&rsquot;s Degree in Social Work after successfulling completing a prescribed course of study at a graduate school of Social Work accredited by the Council on Social Work Education and the Education Dept. and who is certified or licensed by the Education Dept. to practice Social Work in New York State is required.
Experience: Minimum one year social work experience in a health care setting required Utilization management and/or managed care experience preferred. Proficiency in Microsoft Office applications required. Demonstrated analytical skills required.