Qureos Mentor

NYC Health + Hospitals

<div><div><div><h2 class="jobSectionHeader"><b>About NYC Health + Hospitals</b></h2><div><br>
<div><div>
</div><p>MetroPlus<b>Health</b> provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlus<b>Health</b>'s network includes over 27,000 primary care providers, specialists and participating clinics. For more than 40 years, MetroPlus<b>Health</b> has been committed to building strong relationships with its members and providers.</p><div><b>
Position Overview:</b></div><div></div><div><b><i><br>
Empower. Unite. Care.</i></b></div><div></div><div><b><br>
MetroPlusHealth</b> is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.</div><div></div><div><br>
The Behavioral Health Utilization Management (BH UM) Clinician is responsible for conducting utilization and quality management activities in accordance with New York State and MetroPlus<b>Health</b> Utilization Management policies and procedures. The position responsibilities include the management of medical costs through timely prospective, concurrent, and retrospective review activities.</div>
</div></div></div></div><div><div><h2 class="jobSectionHeader"><b>
Work Shifts</b></h2><div><br>
<div><div>
</div><p><b>9:00AM-5:00PM</b></p>
</div></div></div></div><div><div><h2 class="jobSectionHeader"><b>
Duties &amp; Responsibilities</b></h2><div></div><div><div><br>
<p>
</p><ul><li>Performs telephonic review for inpatient and outpatient services using InterQual with Secondary Dimensions &amp; LOCADTR and OMH Criteria Sets</li><li>
Contributes to UM program goals and objectives in containing health care costs and maintains a high-quality medical delivery system through departmental UM procedures</li><li>
Collects all pertinent clinical information and documents within CareConnect</li><li>
Promotes alternative care programs and research available options including costs and appropriateness of patient placement in collaboration with health plan members</li><li>
Communicates directly with Physician providers/designees when appropriate to gather all clinical information to determine the medical necessity of requested healthcare services</li><li>
Communicates with Medical Director regarding all inpatient cases and outpatient/ambulatory requests for health care services that do not meet medical necessity or appropriate level of care and out of network transfer issues</li><li>
Recommends, coordinates, and educates providers regarding alternative care options</li><li>
Educate providers on medication and treatment compliance while also promoting the use of Long Acting Injectables</li><li>
Enlist existing provider network in promoting first episode psychosis treatment.</li><li>
Educate providers to alternate treatment services being promoted by Health + Hospitals in lieu of Inpatient Detox</li><li>
Attends and prepares for bi-Weekly Interdisciplinary Care Team (ICT) meetings which will feature newly enrolled, frequently admitted, high utilizing at risk CORE and HARP members</li><li>
Evaluate housing needs-Collaborating timely with MetroPlusHealth internal housing team for supportive assistance</li><li>
Maintains an active role in assuring the continuity of care for all inpatients through early discharge planning and working with hospital discharge planning staff</li><li>
Identifies potentially catastrophic and high-risk cases for case management referral</li><li>
Identifies and communicates all potential quality of care concerns to the BH UM Clinician Team Lead in a timely manner</li><li>
Contributes to MetroPlusHealth corporate goals through ongoing active team participation, offering input and assistance with development and delivery of education and trainings.</li><li>
Performs other appropriate UM Behavioral Health duties and participates in other special projects as assigned, including, but not limited to, monthly audit review and preparation, quality improvement, community health education, facility/provider relations and marketing activities.</li><li>
Support Coverage for Retrospective Reviews and BH UM Appeals as needed</li></ul>
</div></div></div></div><div><div><h2 class="jobSectionHeader"><b>Minimum Qualifications</b></h2>
<div>
<div></div><div><ul><li>Master&rsquo;s Degree required</li><li>
Minimum 3 years of Behavioral Health (Serious Mental Illness &amp; Substance Use Disorder) experience in managed care utilization review, quality assurance, discharge planning. (Experience working in a Psychiatric Hospital Inpatient and/or Outpatient setting preferred)</li><li>
Previous Experience within the Integrated Collaborative Care Model Approach</li><li>
Experience with chronic condition management, particularly Diabetes, HIV, Heart Disease</li><li>
Pharmacy, Psyckes, E-Paces, LOCADTR, InterQual, Guiding Principles, HCS (UAS) MAPP,</li><li>
Medical Background &amp; Bilingual preferred</li><li>
Previous Quality Management liaison experience with hospitals and other large volume providers to address cost. as well as HEDIS/QARR quality performance, preferred.</li></ul><div></div><div><b><br>
Licensure and/or Certification Required:</b></div><ul><li>
LCSW, LMSW, or LMHC. Current valid unrestricted NY State License.</li></ul><div><b>
Professional Competencies:</b></div><ul><li>
Integrity and Trust</li><li>
Teamwork and Problem-Solving Attitude</li><li>
Customer Service</li><li>
Superior Technical Computer skills (Microsoft Office, Care Connect, Teams Video Application)</li><li>
Exceptional Organizational and Communication Skills.</li><li>
Strong interpersonal and assessment skills, the ability to remain calm and poised with challenging providers</li></ul></div></div></div></div></div>

Behavioral Health Utilization Management Clinician

<div><div><div><h2 class="jobSectionHeader"><b>About NYC Health + Hospitals</b></h2><div><br>
<div><div>
</div><p>NYC Health + Hospitals is the largest public health care system in the United States. We provide essential outpatient, inpatient and home-based services to more than one million New Yorkers every year across the city&rsquo;s five boroughs. Our large health system consists of ambulatory centers, acute care centers, post-acute care/long-term care, rehabilitation programs, Home Care, and Correctional Health Services. Our diverse workforce is uniquely focused on empowering New Yorkers.</p><p>
At NYC Health + Hospitals, our mission is to deliver high quality care health services, without exception. Every employee takes a person-centered approach that exemplifies the ICARE values (Integrity, Compassion, Accountability, Respect, and Excellence) through empathic communication and partnerships between all persons.</p>
</div></div></div></div><div><div><h2 class="jobSectionHeader"><b>
Work Shifts</b></h2><div><div><div><br>
</div><p><br>
<b>9:00 A.M &ndash; 5:00 P.M</b></p><br>
</div></div></div></div><div><div><h2 class="jobSectionHeader"><b>
Duties &amp; Responsibilities</b></h2><div><br>
<div><div>
</div><p><b>Purpose of Position</b>:<br>
<br>
Under the direction of the General Counsel, provides counsel, recommendations, and approaches on a wide-range of legal matters, with or without precedence, relating to legal rights and obligations of the Corporation, business objectives, and maintenance of operations within the boundaries of the law. Handles legal issues and disputes that arise within the Corporation, including issues involving employees, business units, patients, suppliers and various external agencies. Identifies potential legal risks associated with organizational actions and decisions.<br>
<br>
<b>Essential Duties and Responsibilities</b>:<br>
<br>
1. Advises on legal aspects of organizational procedures, policies, regulations, business relationships, communications and related matters, which may have legal implications and impact on the Corporation. Identifies and assesses current and potential legal risks affecting Corporation operations, and advises on the best course of action to mitigate those risks.<br>
<br>
2. Prepares documents and notices required by law, Corporate by-laws, or instructions of the Counsel and corporate officers.<br>
<br>
3. Reviews proposed, existing and pending legislation, including court, administrative decisions and regulations. Communicates findings; prepares comments and recommendations regarding proposed legislation and rulings.<br>
<br>
4. Reviews patents, licensing agreements, and copyrights. Prepares recommendations to protect the legal rights of the Corporation. Supervises preparation and legal review of contracts and licenses and participates in negotiation.<br>
<br>
5. Develops and recommends policies, practices and procedures involving transactions, acquisition or disposal of interest in real property, new legal processes and services, pricing and costing policies, collective bargaining and labor relations and federal, state and local taxes.<br>
<br>
6. Represents Counsel in litigation, including the prosecution and defense of all legal actions brought by or against the Corporation. Monitors the participation of the Corporation in all quasi-judicial proceedings, including administrative, arbitrative, legislative and other similar proceedings calling for the attendance of witnesses or the presentation of written or documentary testimony or evidence.<br>
<br>
7. Supervises and reviews the work of legal staff in pre-trial preparation, legal research, preparation of briefs, opinions, and other related activities.<br>
<br>
8. In the Office of Labor Relations, advises on matters of law, statutes, administrative codes, rules and regulations affecting the operation of the Corporation on legal matters pertaining to labor and employee relations; personnel administration; labor contracts and legislation; and Civil Service Law. Acts as an Assistant to Counsel.<br>
<br>
9. Participates in conferences and meetings regarding legal interpretation of the general body of law that may affect the proposals and intent of parties. Ensures that agreements negotiated are consistent with labor legislation, statutes, administration codes, rules and regulations.<br>
<br>
10. Participates in review of implementation of programs, practices and procedures on personnel, employee and labor relations practices to ensure compliance with the general body of labor and labor relations law, statutes, administrative codes and regulations.<br>
<br>
11. Performs other related duties, as required.</p>
</div></div></div></div><div><div><h2 class="jobSectionHeader"><b>
Minimum Qualifications</b></h2><div><br>
<div><div>
</div><p>Qualification Requirements:<br>
1. Admission and active membership to New York State Bar; and<br>
a. Three (3) years of experience and background in the practice of law subsequent to admission to the Bar<br>
in matters of litigation, negligence, corporate law, contracts, real estate, labor relations, labor law and<br>
employee relations; or<br>
b. Two (2) years of experience and background in the practice of law subsequent to admission to the Bar in<br>
matters of litigation, negligence, corporate law, contracts, real estate, labor relations, employment law<br>
and employee relations; and two (2) years of progressively responsible experience in a professional or<br>
managerial capacity in respective areas applicable to the general body of law, specialties or practice.</p>
</div></div></div></div><div><div><h2 class="jobSectionHeader"><b>
Department Preferences</b></h2>
<div>
<div></div><div><ul><li>4+ years of experience in the area of employment law with significant experience in complex civil litigation</li><li>
experience in litigating civil matters in Federal District Court for the Southern and Eastern District of New York</li><li>
strong judgment and sense of ownership;</li><li>
strong interpersonal, analytical, problem-solving, organizational, drafting, negotiation, and communication skills;</li><li>
ability to manage and prioritize multiple projects; skill in dealing with executive leadership</li><li>
Handling E-discovery</li></ul>
</div></div></div></div><div><div><h2 class="jobSectionHeader"><b>Benefits</b></h2><div><br>
<div><div>
</div><p>NYC Health and Hospitals offers a competitive benefits package that includes:</p><ul><li>
Comprehensive Health Benefits for employees hired to work 20+ hrs. per week</li><li>
Retirement Savings and Pension Plans</li><li>
Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts</li><li>
Loan Forgiveness Programs for eligible employees</li><li>
College tuition discounts and professional development opportunities</li><li>
College Savings Program</li><li>
Union Benefits for eligible titles</li><li>
Multiple employee discounts programs</li><li>
Commuter Benefits Programs</li></ul>
</div></div></div></div><div><div><h2 class="jobSectionHeader"><b>How To Apply</b></h2><div><br>
<div><div>
</div><p>If you wish to apply for this position, please apply online by clicking the &quot;Apply for Job&quot; button.</p></div></div></div></div></div>

Associate Counsel Level B

<div><div><div><h2 class="jobSectionHeader"><b>About NYC Health + Hospitals</b></h2><div><br>
<div><div>
</div><p>NYC Health + Hospitals is the largest public health care system in the United States. We provide essential outpatient, inpatient and home-based services to more than one million New Yorkers every year across the city&rsquo;s five boroughs. Our large health system consists of ambulatory centers, acute care centers, post-acute care/long-term care, rehabilitation programs, Home Care, and Correctional Health Services. Our diverse workforce is uniquely focused on empowering New Yorkers.</p><p>
At NYC Health + Hospitals, our mission is to deliver high quality care health services, without exception. Every employee takes a person-centered approach that exemplifies the ICARE values (Integrity, Compassion, Accountability, Respect, and Excellence) through empathic communication and partnerships between all persons.</p>
</div></div></div></div><div><div><h2 class="jobSectionHeader"><b>
Work Shifts</b></h2><div><br>
<div><div>
</div><p><b>9:00 A.M &ndash; 5:00 P.M</b></p><br>
</div></div></div></div><div><div><h2 class="jobSectionHeader"><b>
Duties &amp; Responsibilities</b></h2><div><br>
<div><div>
</div><p>Purpose of Position:</p><p>
Under direction, supervises or directs a discrete functional area in personnel/labor relations activities or may coordinate and direct several functional areas of specialization. Assists in planning, development and implementation of personnel management, labor relations and human resources administration policies, programs and practices.</p><p>
Examples of Typical Tasks:</p><p>
1. Assesses manpower needs to determine recruitment efforts with special attention to shortage and high turnover positions.<br>
2. Establishes and maintains recruitment services, establishing relationships with community agencies, public employment agencies, educational institutions and media representatives.<br>
3. Develops procedures for recruitment, placement and skill utilization and supervises the procurement, investigation, interview and selection of personnel.<br>
4. Interprets and disseminates Corporate and local personnel policies, rules and regulations.<br>
5. Guides and advises supervisors in the conduct of orientation programs.<br>
6. Directs maintenance and processing of employee personnel records covering all phases of their work history, background and personnel data.<br>
7. Directs employee relations counseling for supervisors and employees regarding personnel problems, job difficulties and development opportunities.<br>
8. Supervises the administration of employee benefits programs, their coordination and counsel and advice to participants.<br>
9. Develops and recommends policies and administers employee services and activities.<br>
10. Establishes and coordinates in-house training activities and acts as liaison with outside agencies in collaborating training and development programs.<br>
11. Coordinates implementation of employee performance review programs and advises supervisors in proper use and application.<br>
12. Determines and analyzes training needs and formulates and develops plans, procedures and training to meet the needs of the facility.<br>
13. Develops and complies training manuals and other training aids and obtains equipment, training films and other visual aids.<br>
14. Initiates programs to improve communications among employees, assesses effectiveness of communication techniques and recommends desired approaches to attain objectives.<br>
15. Coordinates classification determinations at the local level with Corporate policy and plan of titles. 16. Makes recommendation for new classification based on new or changed conditions, duties and responsibilities.<br>
17. Schedules periodic audits to assure conformance to prescribed plan of titles.<br>
18. Collects, analyzes and develops occupational data concerning hospital positions, job qualifications and other position characteristics to facilitate the personnel and administrative process.<br>
19. Conducts periodic surveys of salaries, wages and personnel practices in conjunction with the Hospital Personnel Director.<br>
20. Implements, coordinates and administers wage and job evaluation systems. Coordinates position classification program with operating needs and implements standards governing allocation of positions with recommendations for position pay grades.<br>
21. Supervises labor management programs which involve resolving grievances, counseling supervisors and employees in grievance procedures and functioning as a liaison between union representatives and management.<br>
22. Presides over labor management meetings and provides Department Heads and Administrators with guidelines necessary in proper implementation of counseling and discipline as well as administration of union contracts.<br>
23. May prepare for and participate in appeal proceedings and serves as local management representative in contact with union representatives pertaining to management decisions with regard to disciplinary actions, promotions, demotions, transfers, separations, layoffs, wage and salary adjustments and other personnel transactions affecting employee status.<br>
24. Maintains records, prepares reports in union/management relations and prepares management studies in the area of labor relations.</p>
</div></div></div></div><div><div><h2 class="jobSectionHeader"><b>
Minimum Qualifications</b></h2><div><br>
<div><div>
</div><p>1. A Master's Degree with specialization in Personnel Management, Business Administration, Labor Relations, Psychology or Vocational Guidance, and two years of experience in personnel management or personnel administration in a large governmental agency, hospital or healthcare facility or civic organization or business firm employing at least three-hundred employees, one year of which must have been in a responsible administrative or supervisory capacity; or,<br>
2. A Baccalaureate Degree issued from an accredited college or university, and three years of experience as indicated in (1), two years of which shall have been in a responsible administrative or supervisory capacity. (Experience which consists solely of the maintenance of personnel transactions will not be accepted); or,<br>
3. A satisfactory equivalent combination of education and experience.</p>
</div></div></div></div><div><div><h2 class="jobSectionHeader"><b>
Department Preferences</b></h2>
<div>
<div></div><div><ul><li>5+ years of full-time experience in a similar role within human resources</li><li>
Proficiency in Microsoft Office suite</li><li>
Proficiency in Google Office suite</li><li>
Proficiency with project management tools</li><li>
Knowledge of project management methodologies HR systems / HRIS familiarity (PeopleSoft, Oracle or equivalent).</li><li>
Understanding of data and metrics analysis in an HR context.</li><li>
Strong written and verbal communication skills.</li><li>
Stakeholder engagement and facilitation skills.</li><li>
Ability to prioritize and multitask across concurrent projects and activities.</li><li>
Ability to translate strategic goals into operational projects.</li><li>
Ability to work independently and collaboratively across multiple HR units.</li><li>
Ability to influence without direct authority.</li><li>
Ability to adapt quickly to evolving organizational priorities.</li><li>
Ability to present complex information clearly to different audiences.</li><li>
Demonstrated professionalism and a strong customer service orientation.</li><li>
Ability to handle confidential and sensitive information with integrity and discretion.<br>
</li></ul>
</div></div></div></div><div><div><h2 class="jobSectionHeader"><b>Benefits</b></h2><div><br>
<div><div>
</div><p>NYC Health and Hospitals offers a competitive benefits package that includes:</p><ul><li>
Comprehensive Health Benefits for employees hired to work 20+ hrs. per week</li><li>
Retirement Savings and Pension Plans</li><li>
Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts</li><li>
Loan Forgiveness Programs for eligible employees</li><li>
College tuition discounts and professional development opportunities</li><li>
College Savings Program</li><li>
Union Benefits for eligible titles</li><li>
Multiple employee discounts programs</li><li>
Commuter Benefits Programs</li></ul>
</div></div></div></div><div><div><h2 class="jobSectionHeader"><b>How To Apply</b></h2><div><br>
<div><div>
</div><p>If you wish to apply for this position, please apply online by clicking the &quot;Apply for Job&quot; button.</p></div></div></div></div></div>

Assistant Personnel Director

Join NYC Health + Hospitals and explore 3   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

NYC Health + Hospitals

ABOUT_COMPANY

Behavioral Health Utilization Management Clinician

Associate Counsel Level B

Assistant Personnel Director