Fallon Health

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Job Locations US-NY-Amherst, NY
Posted Date 1 week ago(10/18/2021 2:17 PM)
This is a great new opportunity located in our Buffalo office (Amherst, NY). You will be an integral part of our elder services PACE program joining an established operation but you will have the opportunity to make your own mark and help us grow.         Responsible for supervising the quality and risk management activities of all Fallon Health Weinberg PACE Program. Efforts are focused on the development of systems for collection of clinical and other quality data, analysis and interpretation of data, and implementation and monitoring of corrective action plans. Provides clinical expertise and technical support for quality initiatives. Develops and maintains clinical quality databases. Develops reports and communicates with internal and external customers as needed. CMS Audit coordination. PAC Committee involvement. Quarterly reporting to BOD. Ongoing monitoring in the PACE program to identify areas of improvement. Level 1 and 2 reporting. Oversee QAPI plan, evaluation and amendments.
Job ID
6561
Product Line
Fallon Health Weinberg
Job Locations US-NY-Amherst, NY
Posted Date 4 weeks ago(9/28/2021 6:39 PM)
About Fallon Health Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation’s top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit fallonhealth.org.   About Fallon Health Weinberg - PACE: Fallon Health Weinberg-PACE is a long-term care program for older adults who need a nursing-home level of care, but wish to stay living at home and in their community. We are a Program of All-inclusive Care for the Elderly (PACE), providing complete medical care and support services so you or your loved one can remain living safely at home.  All care is coordinated and provided by an interdisciplinary team specializing in geriatric care, who work with participants and their caregivers to create an individualized care plan.   We are looking for a Personal Care Assistant to perform personal care activities and therapeutic activities at the PACE day health center.
Job ID
6527
Product Line
Fallon Health Weinberg
Job Locations US-NY-Amherst, NY
Posted Date 1 month ago(9/24/2021 11:10 AM)
About Fallon Health Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation’s top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit fallonhealth.org. About Fallon Health Weinberg-PACE: Fallon Health Weinberg-PACE is a long-term care program for older adults who qualify for a nursing-home level of care, but wish to stay living at home and in their community. We are a Program of All-inclusive Care for the Elderly (PACE), providing complete medical care and support services that helps people to remain living safely at home. All care is coordinated and provided by an interdisciplinary team specializing in geriatric care, working with participants and their caregivers to create an individualized care plan.   As part of the PACE interdisciplinary team, responsible for the coordination and monitoring of care and services to maintain participants in a safe community environment.    SUMMARY OF PURPOSE: To make available attractive, nutritious and palatable meals in an efficient, pleasant and clean environment while maintaining federal, state and district guidelines.  Work is performed under the general supervision of the Registered dietitian. The employee also interacts with and takes direction from the day center manager and program Director. The employee is expected to respect the right to privacy and security of PHI (Protected Health Information) and EPHI (Electronic Protected Health Information). Positive and effective interpersonal/communication skills are required.
Job ID
6518
Product Line
Fallon Health Weinberg
Job Locations US-NY-Amherst, NY
Posted Date 1 month ago(9/22/2021 12:03 PM)
About Fallon Health Weinberg - PACE: Fallon Health Weinberg-PACE is a long-term care program for older adults who need a nursing-home level of care, but wish to stay living at home and in their community. We are a Program of All-inclusive Care for the Elderly (PACE), providing complete medical care and support services so you or your loved one can remain living safely at home.  All care is coordinated and provided by an interdisciplinary team specializing in geriatric care, who work with participants and their caregivers to create an individualized care plan.   Summary of position: The employee in this position is responsible for: - Performs personal care activities at the PACE day health center. - Assists in the PACE clinic under the supervision of PACE Nursing staff.  - Assists the PACE participants with therapeutic activities at the PACE Center 
Job ID
6512
Product Line
Fallon Health Weinberg
Job Locations US-NY-Amherst, NY
Posted Date 1 month ago(9/14/2021 12:47 PM)
About Fallon Health Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation’s top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit fallonhealth.org.   About Fallon Health Weinberg-MLTC Fallon Health Weinberg is a partnership between Fallon Health of Massachusetts and Weinberg Campus of Erie County, New York. Fallon Health Weinberg offers a Program of All-Inclusive Care for the Elderly (PACE) and a Managed Long Term Care (MLTC) plan to serve the health needs of dual-eligible residents of the Western New York counties of Erie and Niagara. Fallon Health Weinberg expands the choices that residents of Erie and Niagara Counties have when it comes to high-quality, affordable health care.   All care is coordinated and provided by an interdisciplinary team specializing in geriatric care, who work with participants and their caregivers to create an individualized care plan.   Summary: The Navigator helps the primary care provider, care manager, community liaisons and other providers know at all times what is occurring with the Member and their status. Responsibilities include: placing referrals and following up to ensure services are in place as per the individual care plan; coordinating and documenting Inter-Disciplinary Care Team meetings, facilitating data transfers and ensuring the Centralized Enrollee Record (CER) and Core System is up to date. The Navigator works closely with the Care Manager. The Navigator refers to the Care Manager whenever clinical decision making is required. In order to effectively advocate for Enrollee needs, the Navigator makes in home visits/long term care facility visits with/without the Care Manager to fully understand an Enrollee/member care needs. The Navigator seeks to establish a relationship with the Enrollee/member/caregiver(s)/facilities to better ensure ongoing service provision and care coordination, consistent with the member specific care plan.
Job ID
6506
Product Line
Fallon Health Weinberg
Job Locations US-NY-Amherst, NY
Posted Date 2 months ago(9/8/2021 12:00 PM)
Fallon Health Weinberg is a partnership between Fallon Health of Massachusetts and Weinberg Campus of Erie County, New York. Fallon Health Weinberg offers a Program of All-Inclusive Care for the Elderly (PACE) and a Managed Long Term Care (MLTC) plan to serve the health needs of dual-eligible residents of the Western New York counties of Erie and Niagara. Fallon Health Weinberg expands the choices that residents of Erie and Niagara Counties have when it comes to high-quality, affordable health care. Founded in 1977, Fallon Health provides health care services designed to meet the unique and changing needs of all they serve. It consistently ranks as one of the nation's highest-rated health plans, according to the National Committee for Quality Assurance (NCQA).* Fallon Health coordinates care with its Senior Care Options/Special Needs Plan for dual-eligible people who are 65 and older. Fallon Health has operated a PACE program in Massachusetts for more than 20 years and is the largest PACE program in New England and sixth largest nationally.**   Weinberg Campus has been providing needed services to the elderly for more than 100 years, through both community-based programs and nursing facility care. It is a renowned geriatric education and training institution offering the widest range of housing and care options available on one campus. The two parent companies, Fallon Health and Weinberg Campus, have demonstrated consistent commitment to providing an array of solutions that make high-quality, integrated and affordable care more accessible to the poor, disabled and senior populations within the communities they serve.   Summary: The Director of Clinical Service is accountable for the clinical direction and management of the services of Fallon Health Weinberg MLTC within the FHW service area, including the development, implementation, maintenance and monitoring of all clinical programs and operations as required in the contract between FHW and the New York State Department of Health. The Director works closely with members of the FHW leadership team and the Program Director in developing and administering the clinical program to ensure compliance with all relevant aspects of the NY State Medicaid managed long term care Program.  
Job ID
6493
Product Line
Fallon Health Weinberg
Job Locations US-NY-Amherst, NY
Posted Date 4 months ago(7/9/2021 12:56 PM)
Fallon Health Weinbergis a partnership between Fallon Health of Massachusetts and Weinberg Campus of Erie County, New York. Fallon Health Weinberg offers a Program of All-Inclusive Care for the Elderly (PACE) and a Managed Long Term Care (MLTC) plan to serve the health needs of dual-eligible residents of the Western New York counties of Erie and Niagara. Fallon Health Weinberg expands the choices that residents of Erie and Niagara Counties have when it comes to high-quality, affordable health care. Founded in 1977, Fallon Health provides health care services designed to meet the unique and changing needs of all they serve. It consistently ranks as one of the nation's highest-rated health plans, according to the National Committee for Quality Assurance (NCQA).* Fallon Health coordinates care with its Senior Care Options/Special Needs Plan for dual-eligible people who are 65 and older. Fallon Health has operated a PACE program in Massachusetts for more than 20 years and is the largest PACE program in New England and sixth largest nationally.**   Weinberg Campus has been providing needed services to the elderly for more than 100 years, through both community-based programs and nursing facility care. It is a renowned geriatric education and training institution offering the widest range of housing and care options available on one campus. The two parent companies, Fallon Health and Weinberg Campus, have demonstrated consistent commitment to providing an array of solutions that make high-quality, integrated and affordable care more accessible to the poor, disabled and senior populations within the communities they serve.   Fallon Health Weinberg in Amherst, NY is currently seeking an experienced RN Nurse Care Manager for our quickly expanding MLTC program. This is a full time day, Monday - Friday, RN nursing position. At Fallon Health Weinberg, you’ll find a competitive salary, comprehensive benefits and a stimulating, collaborative culture. Our dedicated professionals truly work as a TEAM, united by compassion for the people we support, each contributing to our innovative approach to health care. Fallon Health Weinberg is increasing access to high-quality, person-centered, cost-effective health care programs for older individuals who require supportive services due to long-term health needs but want to remain living independently in the Buffalo NY community. We currently offer three plans to provide care and care coordination for people in their homes: - Managed Long Term Care Plan (MLTC) - PACE: Program of All Inclusive Care for the Elderly. Under the direction of the Director of Clinical Services (DCS), the FHW Care Manager (CM) is able to work both independently and collaboratively with other members of the FHW Program Primary Care Team. The CM follows established departmental policies and standards for timely completion of assigned work.   Problems lacking clear precedent are reviewed with DCS or her/his designee prior to taking action.   The CM presents a clear definition of problem(s) when reviewing with the Primary Care Team, Primary Care Physician and/or Medical Director.   The FHW Care Manager (CM) assesses a Members clinical/functional status and develops a plan to coordinate a continuum of care consistent with the Members health care needs and/or goals. The Individualized Care Plan (ICP) supports the Member attaining and/or maintaining an optimal functional status. The CM is an active participant in the Members Interdisciplinary Care Team (ICT) and is an advocate for the Member.   The CM is actively involved with the Member at times of care transition, including but not limited to planned and unplanned admissions, and works in conjunction with the members team to ensure care plan communication between all providers and members of the ICT.   The CM coordinates care between multiple medical and Primary Care Team Providers. The CM is able to identify services, care delivery settings, and recommends alternatives where appropriate.    The CM monitors the care and provides consistent feedback to team on progress. The CM collaborates and works with all members of the Interdisciplinary Care Team and, when appropriate, the FHW care manager will work with Acute care hospitals, rehab facilities and skilled nursing facilities to ensure an effective care plan to meet member care needs.  The CM may attend Facility Discharge Planning Rounds and works to ensure a smooth discharge and transition as appropriate    
Job ID
6415
Product Line
Fallon Health Weinberg

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