MAXIMUS RN - Nurse Evaluator - Region 2 - Western NY - Monroe Wayne Livingston Ontario Yates Steuben - Home Health - CYES - NOVEMBER CLASS

JOB SUMMARY

Working in the community conducting strength-based assessments for families who have children (ages 0-21) with behavioral health/psychiatric/medical needs. All nurses are provided support and education for ongoing professional development and annual certification in the CANS-NY assessment tool. The assessments will be the basis for Person-Centered Plan of Care (POC) development to support the family s access to Home and Community Based Services (HCBS).The Nurse Evaluator will support a caseload of consumers through the C-YES process and a caseload of consumers who will remain with C-YES for ongoing HCBS Care Management. This position involves both telehealth and in-person appointments with consumers/families.

JOB RESPONSIBILITIES

1. Develop Home and Community Based Services (HCBS) Plan of Care (POC) in collaboration with child and family that includes evaluation of health status

2. Perform evaluations of children that includes evaluation of health status, strengths, functional care needs, and preferences and guide the development of individualized long-term care service plans

3. Review child s medical documentation and or health referral forms, as relevant to the case

4. Utilize the State CANS assessment tool and MAXIMUS case management systems to document the child s health status, strengths, functional care needs, diagnoses and preferences and transmit, as required

5. Properly document any concerns, conflicting information, other issues that surface during the evaluation process

6. Emphasize continuity of care, thus reducing or eliminating fragmentation, duplication, and gaps in treatment plan

7. Discuss with child/family health care options, supports needed, service vendor options and waiver options

8. Update plans of care as per State requirements, and on an as needed basis

9. Collaborate with Family Support Coordinators to meet the needs of the family

10. Enhance communication and collaborative relationships with interdisciplinary care team members to improve care coordination and facilitate service delivery

11. Collect quality review data and any required documentation to support outcome measurements and record case notes into CRM

12. Provide relevant information in response to the child s specific needs as a bridge between when the in-home evaluation is conducted and evaluation results are provided

13. Maintain a comprehensive working knowledge of community resources and network services for target population

14. Meets all standards established for this position as outlined in the corresponding annual performance criteria and bonus template for this position

15. Performs other duties as may be assigned by the Regional Manager or other project management

REQUIRED SKILLS:

Ability to review health status questions and make evaluations and determinations based on the UAS-CANS-NY system criteria for enrollment; ability to work with technology in the workplace; knowledge of the theory, principles, and practices of general professional nursing; knowledge of state and agency laws and regulations governing general professional nursing practices; excellent organizational, interpersonal, written, and verbal communication skills; ability to communicate and work effectively with multi-generational consumers; ability to demonstrate sensitivity to the concerns of others; ability to perform comfortably in a fast-paced, deadline-oriented work environment; ability to successfully execute many complex tasks simultaneously; and a strong ability to work independently and remotely.