Assistant Director - Transitions of Care (Finance)

NYU Langone Health is a world-class, patient-centered, integrated academic medical center, known for its excellence in clinical care, research, and education. It comprises more than 200 locations throughout the New York area, including five inpatient locations, a children's hospital, three emergency rooms and a level 1 trauma center. Also part of NYU Langone Health is the Laura and Isaac Perlmutter Cancer Center, a National Cancer Institute designated comprehensive cancer center, and NYU Grossman School of Medicine, which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history. At NYU Langone Health, equity, diversity, and inclusion are fundamental values. We strive to be a place where our exceptionally talented faculty, staff, and students of all identities can thrive. We embrace diversity, inclusion, and individual skills, ideas, and knowledge. For more information, go to nyulangone.org, and interact with us on LinkedIn, Glassdoor, Indeed, Facebook, Twitter, YouTube and Instagram.

Position Summary:
We have an exciting opportunity to join our team as a Assistant Director - Transitions of Care (Finance).

In this role, the successful candidate under the guidance of the Assistant Vice President of DSS, the Transitions of Care Liaison will be responsible for partnering with Managed Care payors to optimize the post-acute authorization process for patients requiring services upon hospital discharge. This will include creating standardized processes, implementing best practices, and creating innovative, integrated, data-driven solutions to improve the post-acute authorization process and reduce discharge delays. This position will be instrumental acting as a multidisciplinary liaison across finance, clinical, and operational areas to ensure strategic alignment. As a member of the Decision Support team, this role will also be involved in the day-to-day operations of the system-wide Value Based Management (VBM) initiative, which includes continuous identification of opportunities and implementation of solutions to drive value across all sites of the health system.

Job Responsibilities:

• Address challenges in the post-acute authorization process through collaboration with Managed Care and Care Management/Social Work teams
• Identify trends in post-acute authorization delays and address gaps in Managed Care contracts or escalation processes
• Develop strategies and innovative approaches to reduce delays in post-acute authorization, payor communications, and timely updates of payor policy
• Use evidence-based healthcare literature to advise and support appropriate changes
• Serve as system expert in all post-acute authorization processes for payors
• Serve as a key contact for internal and external stakeholders in the post-acute authorization process
• Serve as subject matter expert for key escalations across the inpatient setting
• Contribute to weekly Long-Stay rounds
• Serve as member of the Process of Care Committee
• Standardize authorization expectations and simplify processes with external payors
• Coordinate communication workflows between Managed Care payors and Care Management/Social Work teams to improve the turnaround time for authorization requests
• Escalate authorization requests to Managed Care team and Managed Care payors when necessary
• Pilot new workflows with payors to reduce avoidable days in the hospital setting
• Develop core principles for discharges to post-acute care facilities to ensure standardized expectations across all payors
• Evaluate risk contracts with post-acute care facilities for improvement opportunities
• Partner with the Managed Care team to provide input in the Managed Care contract negotiations to hold payors accountable for delays
• Stay appraised of local, state, and federal legislation impacting payor authorization (e.g. “Gold Card Legislation”), incorporating in-depth understanding of these regulatory shifts into the short and long-term improvement working closely with the Office of Government & Community Affairs
• Stay appraised of changes to payor workflow changes related to community health emergencies and holidays communicating updates to Care Management/Social Work teams
• Maintain consolidated guide of all post-acute authorization processes and escalation workflows by payor and plan for use by Care Management/Social Work
• Serve as system administrator and superuser for all relevant payor platforms
• Identify areas of opportunity for reporting standardization using both internal and external data sources for referral, authorization and quality metrics
• Measure and track key performance metrics to evaluate the impact of interventions over time
• Leverage benchmarking data to identify further areas of improvement

Minimum Qualifications:
To qualify you must have a Bachelors Degree
8-12 years of work experience in payor-side managed care, including at least 2-4 years working directly with hospitals
Excellent interpersonal and effective communication skills
Record of developing strong relationships between payor and providers to improve transitions of care
Strong organizational skills, creative problem solving, and exceptional critical thinking skills
Ability to multitask high priority items to ensure deadlines and deliverables are achieved
Prior work in improvement initiatives and high value care in a large academic medical center

Preferred Qualifications:
Experience in clinical setting, such as in Nursing, Care Management, or Social Work
Experience with Managed Care on the provider or payor side

Qualified candidates must be able to effectively communicate with all levels of the organization.

NYU Langone Health provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you'll feel good about devoting your time and your talents.

NYU Langone Health is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, gender, gender identity or expression, sex, sexual orientation, transgender status, gender dysphoria, national origin, age, religion, disability, military and veteran status, marital or parental status, citizenship status, genetic information or any other factor which cannot lawfully be used as a basis for an employment decision. We require applications to be completed online.
If you wish to view NYU Langone Health's EEO policies, please click here. Please click here to view the Federal "EEO is the law" poster or visit https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm for more information.

NYU Langone Health provides a salary range to comply with the New York City Law on Salary Transparency in Job Advertisements. The salary range for the role is $110,479.20 - $179,771.53 Annually. Actual salaries depend on a variety of factors, including experience, specialty, education, and hospital need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.

To view the Pay Transparency Notice, please click here