FHW Enrollment Nurse

Fallon Health•Town of Amherst, NY

1d•Hybrid

About The Position

Fallon Health Weinberg is a partnership between Fallon Health of Massachusetts and Weinberg Campus of Erie County, New York. Fallon Health Weinberg offers a Program of All Inclusive Care for the Elderly (PACE) to serve the health needs of dual-eligible residents of the Western New York counties of Erie and Niagara. Fallon Health is a company that cares. We prioritize our members--always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, we deliver equitable, high-quality coordinated care and are continually rated among the nation’s top health plans for member experience, service, and clinical quality. Weinberg Campus has been providing needed services to the elderly for more than 100 years, through both community-based programs and nursing facility care. It is a renowned geriatric education and training institution offering the widest range of housing and care options available on one campus. At Fallon Health Weinberg, we believe our individual differences, life experiences, knowledge, self-expression and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status and other characteristics that make people unique.

Requirements

Degree in Nursing; BSN preferable
RN, current license to practice in New York
NY drivers license
Minimum of 2 years experience working with the elderly, preferably in a community setting

Nice To Haves

Knowledge of UAS-NY Assessment process desireable
Knowledge of Medicaid eligibility requirements desireable

Responsibilities

Participates in establishing monthly goals for enrollment
May responds to individual inquiries regarding Fallon HealthWeinberg, including but not limited to, phone calls, web site inquiries, home visits, hospital and nursing home visits
Reviews the enrollment process and the Fallon Health Weinberg Care Member Handbook with potential members/families.
Completes the UAS-NY, estimates whether individual meets clinical criteria for enrollment, and submits UAS-NY.
Develops and communicates initial Care plan for new members into the MLTC
Communicates with the Care Teams to provide information for enrollment decisions and provides ongoing communication with referral sources, potential enrollees/families during the intake process
Coordinates and communicates necessary information about potential enrollees to the Program Director on an ongoing basis
Closely monitors progress of pre-enrollment activities and notifies the Program Director of potential issues
Provides referrals for individuals not appropriate for FHW and for those who choose not to enroll
Participates in weekly intake meetings
Identifies Quality Improvement issues to the Program Director and participates in the development and implementation of the FHW Quality Improvement Plan as directed
Assures uniformity in data collection
Prepares monthly reports regarding referrals and enrollments