Assessment Nurse Case Manager

Fallon Health • Worcester, MA

2d • $95,000 - $100,000 • Hybrid

About The Position

The Assessment Nurse Case Manager completes face-to-face home visits for new enrollees within 30 days of enrollment to onboard and completes regulatory assessments. The Assessment Nurse Case Manager completes in person Health Risk Assessments (HRAs) in accordance with members assigned frequency. The Assessment Nurse Case Manager completes all new Personal Care Attendant (PCA) Assessments using the integrated time for task tool and well as yearly PCA reevaluations. The Assessment Nurse Case Manager is also responsible for the timely and accurate submission of yearly (and when there is a significant change in status) MDS assessments. Assessments are done primarily in person but may at times be completed telephonically.

Requirements

• Graduate from an accredited school of nursing
• Active, unrestricted license as a Registered Nurse in Massachusetts
• 1+ years of clinical RN experience with complex medical, behavioral, and social co-morbidities.
• Ability to conduct assessments in-person and telehealth.
• Ability to work on interdisciplinary teams.
• Skill in screening social determinants of health.
• Strong communication and interviewing skills.
• Problem-solving skills and adaptability.
• Knowledge or willingness to learn regulatory requirements.
• Must possess a valid drivers’ license
• Must attest to no disqualifiers per Driver Safety Policy
• Must possess and provide proof of minimal state required auto insurance
• Must have reliable transportation
• Reliable home internet.

Nice To Haves

• Bachelors (or advanced) degree in nursing or a health care related field
• Certification in Case Management
• Home Health, OASIS/MDS, Medicare/Medicaid, face-to-face member interactions.

Responsibilities

• Conducts home visits for onboarding and regulatory assessments.
• Completes HRAs and PCA assessments.
• Submits MDS assessments.
• Provides education on NaviCare case management program.
• Conducts telephonic assessments when appropriate.
• Collaborates with Care Team.
• Completes LTSS evaluations and collaborates with UM.
• Conducts in-home assessments with motivational and culturally sensitive interviewing.
• Performs medication reconciliation.
• Completes State-required assessment tools per contract.
• Conducts functional assessments for LTSS programs.
• Participates in training and audits.
• Completes telephonic/virtual assessments.
• Maintains program/policy knowledge to educate members.
• Supports HEDIS, Medicare 5 Star, and other initiatives.

Benefits

• Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level