Clinical Manager-Geriatric and Palliative Care

Clinical Manager is responsible for overseeing the continuity of patient care in the ALIGN-CARE Geriatric Surgery Co-Management program. Patients will be 65 years or older, frail, community-based, considering surgery. Estimated program size will begin at around 50 patients and grow to 200-250 by the 2^nd year.

• Patients will be initially seen in the outpatient setting, assessed for surgical risks, and provided care plans to optimize health prior to the surgery. The nurse Clinical Manager will be responsible for components of team-based initial assessment of patient candidates, as well as follow-up tracking and phone calls for education and counseling pre-hospitalization, peri-operatively, and post-operatively. Following discharge from the hospital, Clinical Manager will follow-up with the patient via telephone and transitional care management workflow for optimal post-operative care with the mission to reduce unnecessary return to the emergency room or hospitalization. Of note, patients enrolled in the program may come from any part of Mount Sinai Health System, however hospitals of care receipt will be both Mount Sinai Hospital and Mount Sinai Morningside hospital — therefore the nurse CLINICAL MANAGER should have access to both hospital domains for telephonic and video visit (virtual) care, and sometimes in-person care (outpatient clinic). 
• The nurse Clinical Manager will report to the Geriatrician program director (Dr. Stephanie Chow) and work alongside interdisciplinary team members (administrative associate, nurse practitioner, care coordinator, and social worker) within the Brookdale Department of Geriatric and Palliative Care Medicine. The Clinical Manager will not be expected to have repartees. The Clinical Manager may also work with medical trainees (ie. medical students or geriatric medicine fellows). The Clinical Manager will be responsible for tracking patients throughout the program (Pre-, Peri-, Post-operatively) in a secure patient database, document clinical encounters in EpicCare EMR, providing patient and caregiver instruction and coaching, and corresponding with surgical teams (surgeon, physician assistant, nurse practitioner, administrative assistants) and extended care team (physical therapist, visiting nurses, pharmacists, etc) as needed. 
• Program evaluation and Development:  The nurse Clinical Manager will oversee the collection, compilation, and analysis of clinical program activity data to evaluate clinical performance and competence. The Clinical Manager will be responsible for generating biweekly and monthly reports of program progress and performance, specific to each surgical team and primary care provider, and presenting reports to stakeholder and team members as needed to facilitate ALIGN-CARE program growth, research, and development.

BS in a health related profession, i.e. Nursing, PA, Physiology (Masters preferred), with current licensure. Nursing or Physicians Assistant experience preferred.

MS in Exercise Physiology preferred if the position is utilized in this particular clinical area

5+ Years(higher preferred) clinical experience with 2 years of management and supervisory experience preferred.

Non-Bargaining Unit, 851 - Geriatrics and Palliative Care - ISM, Icahn School of Medicine