MAXIMUS RN - Out of State - Specialist-Nurse Ops Nurse Assessors-

Required Licensure-

Current RN Licensure in New York State

Required Experience-

Two (2) years of experience in a HOME setting within the last ten (10) years.

At a minimum, nurses must have recent experience conducting comprehensive assessments of patients

QUALIFICATION TYPE

QUALIFICATION DESCRIPTION

REQUIRED: All nurse assessors MUST meet the following requirements

Two (2) years of experience in a HOME setting within the last ten (10) years; this may include:

Working in the field for a Certified Home Health Agency (CHHA), Licensed Home Care Service Agency (LHCSA), or Managed Long-Term Care (MLTC)

Conducting assessments that are similar to the UAS such as OASIS

Providing primary care to homebound persons

Care management for persons receiving home and community-based services including Hospice and Assisted Living

Home care experience as a paraprofessional (e.g., Home Health Aide) or Licensed Practical Nurse

PREFERED: In addition to meeting the required qualifications, the additional experience represents the gold standard candidate for this position

Experience conducting assessments in UAS-NY (role 40 or 45), especially in the last 365 days

Experience caring for a geriatric population and managing their chronic diseases, especially in the home setting

OTHER: The following are examples of experience that may count toward preferred qualifications, but does not satisfy the required qualifications on their own

Home care experience with only one patient (i.e., private duty nursing)

Case management that is limited to utilization reviews for a health plan or a combination of hospital and health plan case management

Assessments that were all conducted telephonically and did not involve going into the home

**NOW RECRUITING ***

JOB SUMMARY

Ability to review health status questions and make evaluations and determinations based on UAS 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.

JOB RESPONSIBILITIES

1. Perform initial in-home pre-evaluation of patients that includes evaluation of health status, strengths, care needs, and preferences and guides the development of individualized long term care service plans

2. Review consumer medical documentation and or health referral forms, as relevant to the case

3. Enter evaluation data into electronic evaluation form and transmit, as required

4. Document any concerns, conflicting information, other issues that surface during the evaluation process

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

6. Discuss with consumer on health care options, supports needed, service vendor options and waiver options

7. Initiate communication between the Call Center and eligible consumers for enrollment into a managed care health plan

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

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

10. Identify opportunities for health promotion and illness prevention

11. Maintain a comprehensive working knowledge of community resources, payor requirements, and network services for target population

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

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