Duties/Responsibilities:
· Conducts telephonic and virtual home assessments for prospective members and re-assessments of current members using the Uniform Assessment System (UAS) or other relevant department approved assessment tool; makes enrollment and continued eligibility determinations by utilizing clinical expertise and critical thinking skills. As needed, conducts telephonic/virtual assessments in settings other than home, e.g. skilled nursing facilities
· Completes assessment of member’s needs at the member's, caregiver’s and/or CMT’s request due to a change in condition
· Reviews previous nursing assessments and medical notes to determine necessary adjustments and updates to the Care Plan and/or to assist with nursing home placement eligibility
· Liaisons between the member and the CMT; assesses home environment and psychosocial status
· Coordinates with home care agencies, vendors, pharmacies, medical providers and CMT regarding needs identified
· Provides feedback to home care agencies and CMT regarding home care issues and contract nurses and aides performance
· Provides community-based education for our frail population including self-care techniques and preventative care strategies
· Ensures (prospective) members and significant others/responsible parties understand and agree with enrollment into the managed long-term care plan
· Additional duties as assigned, including, but not limited to care management tasks as needed
Minimum Qualifications:
· New York State RN license
· Valid NY state driver’s license or NYS DMV ID
· Work experience involving time management, critical/creative thinking, communication, and problem-solving skills
· Demonstrated ability to work independently and handle high volume caseloads
Preferred Qualifications:
· Previous field-based experience assessing, planning, and evaluating member's care by making home or facility visits for intake/reassessments or start of care (SOC) Community Home Health Agency (CHHA) visits is highly preferred
· Work experience preferred in one or more of the following areas: Geriatrics, Home Care, Discharge Planning, Case Management, Medical Surgical Nursing
· Electronic patient health information (PHI) database experience
· Knowledge of health insurance, Medicaid, Medicare and MLTCP
· Experience working with a frail adult or elderly population with the ability to determine appropriate care plans and services as well as negotiate initial service plans so that members and families are in agreement
· Time management, critical/creative thinking, communication, and problem-solving skills
· Language preferences - Spanish, Russian, French, Creole, Mandarin, Cantonese
· Intermediate skills using Microsoft Word, Excel, and Outlook
Hiring Range*:
Greater New York City Area (NY, NJ, CT residents): $81,100 - $117,470
All Other Locations (within approved locations): $71,600 - $106,505
As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.
In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.
*The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.