JOB PURPOSE:

The Palliative Care NP Program Manager works in conjunction with the Interdisciplinary Team (IDT) and Transitions in Care team in coordinating and providing care to services under the direction of the PACE Medical Director. The main function of the Palliative Care Nurse Practitioner Supervisor will be to provide clinical support and coordination to palliative care participants and family members.

JOB RESPONSIBILITIES:

• Manages a cohort of participants with complex care need including frailty, multiple chronic illnesses and end of life care.

• Conducts thorough assessments of members identified as having complex and Palliative Care needs including but not limited to: accurate history and physical assessment; medication reconciliation; goals of care identification, psychosocial/spiritual needs assessment; symptom management identification, plan, and implementation of appropriate medical interventions.

• Determines and documents appropriate follow-up plans in line with member goals and communicates these plans with member and caregivers.

• Completes Advance Care Planning documents.

• Reviews and includes the most appropriate diagnosis codes, in addition to correct billing and procedure codes.

• Engages other team members to help address needs of members, through participation in family meetings or referrals as needed.

• Collaborates with and provides recommendations for outside providers. Documents these suggestions and contacts providers.

• Orders, provides oversight of, and coordinates delivery of prescriptions pertaining to the management of advancing disease processes for members enrolled in the palliative program and on the end-of-life panel.

• Evaluates patients within 72 hours of palliative referral placement and completes documentation within 24 hours of visit.

• Engages with outside providers in a partnership driven way. Identifies and suggests opportunities for education that may help further understanding of palliative care tenants to continue engagement.

• Participates in multidisciplinary team meetings and works towards palliative care strategic objectives.

• Mentors new staff as requested.

• Problem-solves local issues and engages in professional conflict management.

• Possesses system thinking abilities and commitment to process improvement. Identifies and communicates opportunities for operational improvement under the direction of Palliative Program Director to improve the health of the CenterLight population.

• Assesses appropriateness of incoming requests and team's processes over time to suggest opportunities for improvement.

• Has a design, innovation and a program development mindset.

• Participates in workgroups as requested for process or service delivery improvement.

• Provides education to stakeholders as requested.

• Shows an ongoing commitment to learning about the tenants of Palliative Care through ongoing pursuit of education.

• Provide clinical care to members in person at times (in-home, or at the Diagnostic Treatment Center), as needed, or via telehealth technologies (video, chat, etc.) for appropriate clinical care and care management services.

• Available to perform home visits in different boroughs occasionally as needed.

• Ability to travel throughout NYC metropolitan area.

• Flexibility to travel up to 50% of the time.

• Only act within the scope of the individual’s authority to practice.

• Meet a standardized set of competencies for the specific position description established by the PACE organization before working independently.

Schedule: 8:30AM – 5:30PM

Weekly Hours: 40

QUALIFICATIONS:

Education: Graduated from a nurse practitioner education program acceptable to NYSED or be certified as a nurse practitioner by a national certifying organization acceptable to NYSED.

Experience:

• Minimum of two (2) years as a nurse practitioner in complex care and palliative/hospice care.

• A background in managed care, digital heath or startups is preferred.

• Highly engaged and motivated

• A change agent who can influence and lead in different settings.

• Ability to manage multiple projects and meet project deadlines.

• Agility in thinking and interest in clinical programs development.

• Understanding of current principles, methods, and procedures for the delivery of medical evaluation, diagnosis, and treatment in palliative care.

• Strong communication, interpersonal skills, and the ability to work effectively and compassionately with a diverse elderly, medically frail population with a myriad of cultural complexities and sensitivities.

• Experience with interdisciplinary team partnership and the managed care model.

• Ability and willingness to work collaboratively with primary care providers and other members of the interdisciplinary team to provide appropriate palliative care services to participants.

• Knowledge of and experience with advanced care planning and goals of care discussions, including end of life wishes. This includes the ability and willingness to discuss symptoms, diagnoses, and prognosis clearly and openly with participants and their families.

License:

• Active and unrestricted license to practice as a Nurse Practitioner in NY.

• Has Provider Transaction Access Number (PTAN).

• DEA Certification required.

• AANP or ANCC Board Certification required.

  Additional Requirements:

• Be legally authorized (for example, currently licensed, registered, or certified if applicable) to practice in the State in which the healthcare professional will perform the function.

• Be medically cleared for communicable diseases and have all immunizations up-to-date before engaging in direct participant contact.

• Must have a Medicaid Provider ID and a Medicare Provider ID in good standing.

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 ability to lift patients safely and using OSHA guidelines, etc.

• Bending/Squatting – Must be able to safely bend or squat to care for patients, use medical supplies, etc.

• Stairs/Steps/Walking/Climbing – Must be able to safely maneuver stairs, climb up/down, and walk to access work areas Position requires the individual to be able to travel, and walk between sites/locations and work areas throughout the day.

• Agility/Fine Motor Skills - Must demonstrate agility and fine motor skills to operate and activate equipment, devices, instruments, and tools (ie. typing, use of medical supplies, equipment, etc.)

• Sight/Visual Requirements – Must be able to visually assess patients, read orders 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, providers, etc., and intake information through audio processing with accuracy. In addition, 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):$175,000.00 - $185,000.00

CenterLight Healthcare is one of the oldest non-profit comprehensive healthcare organizations in the United States. We are a premier provider of home and community-based healthcare and services in the New York metropolitan area, serving all five boroughs of New York City, as well as Westchester, Nassau and Suffolk Counties.

Through CenterLight TeamCare, we offer comprehensive healthcare and other services that enrich the lives of our participants and let them live safely at home and in their communities. TeamCare, a program of CenterLight Healthcare, is the nation’s largest not-for-profit Program of All-Inclusive Care for the Elderly (PACE). Each day, our employees serve a richly diverse population of 3,300 participants, speaking 75 languages and dialects throughout our 14 facilities. Learn more at www.centerlightteamcare.org.

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