Nurse Reviewer - Complaint Intake 

(Albany, NY) 
 

Duties Description:

The New York State Department of Health Office of Primary Care and Health Systems Management Center for Health Care Provider Services and Oversight Division of Nursing Homes and ICF/IID Surveillance Central Complaint Intake Program seeking to fill a Nurse Intake Specialist position in Albany, New York.

Duties include:

•  Receipt of Complaints and Incidents via telephone, fax, email or written correspondence.
•  Screen complaints to determine authority having jurisdiction, if the complaint will be entered in a federal database and complete all appropriate activities associated with the complaint intake process.
•  Triage by determining CMS defined priority level and allegation category.
•  Assign complaint cases to appropriate regional office.
•  Participate in regularly scheduled case review meetings to determine the priority and disposition of each complaint.
•  Contact complainants if additional information is required to clarify their concerns.
•  Identify those complaints that can be resolved by contacting the facility or complainant directly.
•  Respond to general inquiries regarding the complaint process.
•  As determined in case review meetings, make a referral to another Bureau within the Department or Sate agency, per NYSDOH policies and procedures (e.g., Office of Professional Medical Conduct, State Education Department).
•  Participate in process improvement activities as needed.
•  Educate facilities on how to submit incident reports to the department.
•  Provide support and assistance to regional offices as needed.
•  Participate in training and continuing education activities as required by the Department.
•  Conduct and participate in internal quality improvement reviews to monitor program performance.
•  Assist the Department with the completion of tasks, as needed, to meet the requirements of a comprehensive complaint reporting program.
• This position will require rotational call on weekends and holidays for on call coverage. 
• Rotational schedule is determined by a team of 4 total CCIP staff.

Basic Qualifications:

Minimum qualifications include a Registered Professional Nurse currently licensed in New York, the ability to receive, review and triage complaints and incidents for the Division of Nursing Homes and ICF/IID Surveillance Central Complaint Intake Program, ability to work on a team and handle multiple, shifting priorities, demanding deadlines, good organizational skills, ability to correspond with complainants, healthcare professionals and general public and familiarity working in electronic databases. 

Preferred Qualifications:

Preferred qualifications include familiarity and knowledge of nursing home regulations, excellent telephone and written communication skills and experience with the federal CMS ASPEN Suite; Two (2) years of experience performing utilization review, medical review, fraud investigations, surveillance or monitoring activities at the facility level; Three (3) years of clinical experience in a medical facility, preferably a nursing home. Prior experience working in the Office of Primary Care and Health Systems Management’s Center for Health Care Provider Services and Oversight Division of Nursing Homes and ICF/IID Surveillance Central Complaint Intake Program is preferred.   

Compensation for roles at Staffing Solutions Organization LLC (SSO) varies depending on a wide array of factors including, but not limited to, the specific office location, role, skill set, and level of experience. As required by applicable law, SSO provides the following reasonable range of compensation for this role: $65,000-$75,000.  In addition, SSO provides a range of benefits for this role.

Public Consulting Group is an Equal Opportunity Employer dedicated to celebrating diversity and intentionally creating a culture of inclusion. We believe that we work best when our employees feel empowered and accepted, and that starts by honoring each of our unique life experiences. At PCG, all aspects of employment regarding recruitment, hiring, training, promotion, compensation, benefits, transfers, layoffs, return from layoff, company-sponsored training, education, and social and recreational programs are based on merit, business needs, job requirements, and individual qualifications. We do not discriminate on the basis of race, color, religion or belief, national, social, or ethnic origin, sex, gender identity and/or expression, age, physical, mental, or sensory disability, sexual orientation, marital, civil union, or domestic partnership status, past or present military service, citizenship status, family medical history or genetic information, family or parental status, or any other status protected under federal, state, or local law. PCG will not tolerate discrimination or harassment based on any of these characteristics. PCG believes in health, equality, and prosperity for everyone so we can succeed in changing the ways the public sector, including health, education, technology and human services industries, work.