Intake Manager, RN

Under the direct supervision of the Vice President of Operations, the Intake Manager provides administrative support and leadership to the Intake Department and its staff. The Intake Manager is responsible for the daily operation of the components and duties of the Intake Coordinators, Customer Service Representatives, and Level of Care Nurse(s). Oversees the overall enrollment continuum ensuring efficient, accurate, and complete processing of all the required elements of the PACE application process. Ensures all phases of the enrollment process are executed in compliance with State and Federal regulations. Works closely with the Marketing Department Manager, Center Directors, Director of Nursing, and the Medical Director to coordinate processing and assessment of referral applications. Tracks and trends enrollment and census data, reporting to Executive Management as necessary.

ADMINISTRATIVE RESPONSIBILITIES: 1. Conducts employee performance evaluations of Intake staff; monitors and promotes continuous improvement of staff skills, proficiencies and productivity. 2. Completes performance improvement counseling and disciplinary actions, as necessary, for Intake Department staff in coordination with Human Resources. 3. Coordinates with Human Resources in the recruiting, interviewing, and hiring for staff vacancies, as necessary. 4. Reviews time sheets and mileage logs for Department staff to verify accuracy and timeliness in submission. 5. Develops, administers, and monitors the Intake Department budget and ensures department activities operate within fiscal year parameters.

DEPARTMENT OPERATIONS: 1. Provides supervision and direction to Intake Coordinators (LVNs), Level of Care Nurse, and Customer Service Representatives. Ensures Intake staff conduct home visits as scheduled to determine if Program applicants are appropriate and eligible for PACE Program Enrollment. 2. Ensures that the nursing components of the applicants’ intake packets are accurate and in compliance with PACE standards and nursing practices. 3. Collaborates with Clinic Managers to coordinate medical certification appointments for each prospective participant’s MN-LOC Packet. 4. Participates in IDT meetings, as needed, to communicate applicant issues and census information. 5. Facilitates weekly Department meetings with Intake staff, and as needed, to discuss referral processing, quality/performance metrics, any staffing and operational issues, as well as disseminating any relevant Organizational news and information. 6. Works in conjunction with the HHSC Medicaid Eligibility Worker(s) to ensure financial evaluation of applicants is conducted in an efficient and expeditious manner for approval. 7. Meets weekly with the Vice President of Center Operations for review of census and enrollment data, and discussion of any Department-relevant issues. 8. Participates in New Employee Orientation; conducts introductory presentation to NEO class providing an overview of the general Intake process, purpose and goals. 9. Communicates any enrollment issues to Management so as to quickly problem solve and initiate a plan of action to effectuate a successful enrollment. 10. Ensures projected individual Center census is reported on a monthly basis and at Census Management meetings, and alerts Management of any potential imbalances to Center panels. 11. Tracks and reports on various metrics related to the enrollment process to include home visits, drop-offs, census, and conversion rates to Management. 12. Develops denial letters for applicants that are denied medical necessity under PACE guidelines and procedures. Ensures all proper notifications are made when a denial occurs (e.g., Management, IDT, applicants, etc.). 13. Ensures Level of Care Packets for Initial Enrollment and for Medical Necessity Recertifications are completed accurately and within required deadlines. 14. Ensures Medical Necessity/Level of Care Nurse maintains Medical Necessity Logs to include approvals, denials, and deemed/waived participants. Ensures logs are accurate and audited on a regular basis. 15. Ensures Level of Care Packets are electronically transmitted to TMHP by required deadlines and any ‘Action Required’ notifications are promptly addressed. 16. Reviews Intake Disposition Forms and assures completeness and accuracy of information. 17. Maintains active RUG (LOC) Certification. 18. Works closely with Marketing Manager to ensure referral information and data is seamlessly transitioned from the Marketing to the Intake workflow for tracking and initiation of the enrollment process to ultimately yield successful enrollment conversions. 19. Participants in Quarterly CMS reporting meetings; coordinates with the Quality Improvement Department to prepare and present quarterly Enrollments data. 20. Performs other duties as assigned by the Vice President of Center Operations.

Required Skills

KNOWLEDGE/SKILLS/ABILITIES 

1. A dependable individual with a strong knowledge base and keen understanding and appreciation of the elderly. 2. The skill to work collaboratively and communicate (both verbally and in writing) effectively with staff, State contacts, participants, and family members; a team player with the ability to work with an Interdisciplinary team.3. A highly organized individual with superior time management skills. 4.Must possess critical thinking skills, the ability to problem solve, and function independently. 5. The ability to delegate responsibility appropriately, as well as accept supervision. 6. Bilingual (English/Spanish). 7. Must have reliable transportation, valid driver’s license and insurance. 8. Must achieve RUG Certification prior to or within three months of hire. j. Be able to work in a fast paced, high stress environment and meet deadlines.

Required Experience

EDUCATION/EXPERIENCE 

A graduate of an accredited nursing program with a license to practice in the State of Texas as a Registered Nurse preferred

Bachelor’s Degree in Public Health, Healthcare Management, Business or Nursing Management or related fields; relevant course work and/or employment experience may be considered.

Proficiency working with CRM software and MS Office Suite.

One year experience working with a frail or elderly population preferred.

Two years of supervisory experience.

Experience analyzing data, developing reports, and verbally presenting analysis/conclusions/recommendations.

RUG Certification prior to or within three months of hire may be required.