Eligibility RN

InnovAge•Salem, VA

11h•Onsite

About The Position

The Eligibility RN is part of the In-Home Services team and partners with the local Enrollment team to determine if prospective participants meet the guidelines for enrolling in the PACE program. Schedules and conducts home visits, to make level of care assessments to appropriately determine participant eligibility. Completes respective documentation, in close collaboration with the InnovAge Primary Care Physician, and compiling supporting documentation for enrollment. Participates and assists with outreach programs. Serve as member of the Interdisciplinary Team (IDT), and coordinate appointments for prospects that require further assessments by other IDT members. Participates in the case management of peer review of client records and provides consultation to case managers and other staff members regarding medical and nursing issues. Maintain knowledge and expertise in eligibility, enrollment, and program specifications for the Federal and State health coverage programs Medicare and Medicaid, and specifically as those guidelines apply to the Program of All Inclusive Care for the Elderly (PACE). As a member of the In Hom Services team, assists in completing in home assessments, reassessments, supervisory visits, and routine RN care as scheduled and needed by department.

Requirements

Associate degree from accredited nursing school.
Current Registered Nurses License in state in which working.
Current First Aid and BLS certifications are required prior to hire.
3+ years health care experience with emphasis in geriatrics.
1+ year working with the frail or elderly.

Nice To Haves

Bachelor’s in nursing.
Certification as a Gerontological Nurse.
Prior experience working with State and Federal Regulators.
Bi-lingual.

Responsibilities

Determine if prospective participants meet the guidelines for enrolling in the PACE program.
Schedule and conduct home visits to make level of care assessments.
Complete documentation in collaboration with the InnovAge Primary Care Physician.
Compile supporting documentation for enrollment.
Participate and assist with outreach programs.
Serve as a member of the Interdisciplinary Team (IDT).
Coordinate appointments for prospects requiring further assessments by other IDT members.
Participate in case management of peer review of client records.
Provide consultation to case managers and other staff members regarding medical and nursing issues.
Maintain knowledge and expertise in eligibility, enrollment, and program specifications for Medicare and Medicaid as they apply to PACE.
Assist in completing in-home assessments, reassessments, supervisory visits, and routine RN care.