HCBS Assessor

DIRECTION HOME OF EASTERN OHIO•Youngstown, OH

4d•Onsite

About The Position

Under the general supervision of the Director of Home and Community Based Services and the direct supervision of their immediate Supervisor, Assessor will be responsible to complete Pre Admission (PASSR) Reviews, Home Choice Assessments and Medical Mutual of Ohio (MMO) transition coaching. HCBS Assessor Responsibilities: Responsible for maintaining current licensure as a Registered Nurse. Maintains minimum proficiency in all requisite computer applications and software. Participate in and contribute toward accomplishment of divisional and Agency goals. Expected productivity standards/outcomes are to be maintained. Promotes positive employee relations and fosters excellent customer service. Maintains consumer and provider confidentiality according to HIPAA and Agency policy. Meets timeframes for timely and accurate completion of documentation. Maintains documentation in appropriate computer system. Participates in training to maintain and improve job skills. Performs duties with respectful communications and behaviors. Conducts face-to-face home visit with the MMO patient and family/caregiver utilizing the Coleman Like model to provide education on admitting diagnosis, ensure physician follow up, support the individual in understanding paperwork received at hospitalization/skilled nursing facility and complete various assessments Educate MMO patients on 4 pillars of health including but not limited to Red flags identified, Personal Health record, Medication review and importance of physician follow up, Long term services and supports in the community. Conduct medication reconciliation with MMO, educate on indication for use, and relay concerns to physician. Refine, review and create a medication management system with patients. Conduct falls risk assessment at face-to-face visit, educate MMO patients on risks identified and how to mitigate risks. Identify goals with MMO patients. Make referrals to Medical Mutual Case management team as needed Fax physician summary and falls risk assessment to physician for review after MMO Coaching home visit Complete first follow up home call with MMO patient after follow up appointment with physician or about 7- 10 days after the face-to-face visit Completed 2nd and final follow up call 30 days after the MMO face-to-face visit. Complete 3rd follow up phone call with member if they are determined to be at higher risk for readmission. Within follow up phone calls MMO Transition coach should be readdressing items from the home visit that occurred including but not limited to medication reconciliation, 4 pillars of health, goals and referral’s made Conducts face-to-face Home Choice comprehensive assessment (physical, cognitive, social, emotional, financial, and environmental) with the client and anyone of their choosing, obtaining and evaluating data to determine program eligibility, care needs, and service options. Report recommendation of the enrollment appropriateness to the HOME Choice Unit in Columbus. Make referrals to HCBS waiver programs as necessary and other community services and supports. Advocates on behalf of a client for other services and benefits in the community, making referrals to Adult Protective Services and applicable authorities to ensure health and safety of the consumer. Ensure timely reporting to all mandated agencies as per Ohio law. Working knowledge of Medicare, Medicaid and third-party reimbursement and Community service delivery systems with the ability to link consumers to community resources. Pre-Admission Review Representatives reviews PASRR, and UPAR compliance and determinations for long term care applicants. Process PAS/ID, LOC and UPAR determinations per Ohio Administrative Code and Department of Job and Family Services standards. Pre-Admission review Representatives determine Level of Care (LOC) requests received from Nursing facilities and Hospital’s. Assign delayed assessment per ODA rule based on PAR determination so a face-to-face assessment may be completed. Provide Pre-Admission Review technical assistance Evaluate PAS/ID, Level of Care (LOC) and UPAR requests. Make Community referrals as needed Perform other duties as assigned by immediate supervisor and/or management team.

Requirements

Applicant must be a Registered Nurse with an unencumbered license with at least one year’s prior experience in home health care, medical social work and/or geriatrics.
The applicant shall possess the knowledge and skills necessary to provide the level of assessment required by the client and by any legal regulations.
Applicant shall understand 1.) Medicare, Medicaid, and third-party reimbursement and 2.) Community service delivery systems and the ability to utilize the community's resources.
OSHIIP certification, if not already certified, must obtain certification within one year of hire date.
Applicant must possess a valid driver’s license and proof of automobile insurance.
Must also pass a criminal background check and drug screen.

Responsibilities

Maintaining current licensure as a Registered Nurse.
Maintaining minimum proficiency in all requisite computer applications and software.
Participating in and contribute toward accomplishment of divisional and Agency goals.
Maintaining expected productivity standards/outcomes.
Promoting positive employee relations and fosters excellent customer service.
Maintaining consumer and provider confidentiality according to HIPAA and Agency policy.
Meeting timeframes for timely and accurate completion of documentation and maintaining documentation in appropriate computer system.
Participating in training to maintain and improve job skills.
Performing duties with respectful communications and behaviors.
Conducting face-to-face home visits with patients and families/caregivers to provide education, ensure physician follow up, support understanding of paperwork, and complete assessments
Educating patients on 4 pillars of health.
Conducting medication reconciliation, educating on medication use, and relaying concerns to physicians.
Conducting falls risk assessments, educating patients on risks, and how to mitigate risks.
Identifying goals with patients.
Making referrals to Medical Mutual Case management team as needed
Faxing physician summaries and falls risk assessments to physicians for review.
Completing follow up calls with patients.
Conducting face-to-face Home Choice comprehensive assessments to determine program eligibility, care needs, and service options.
Reporting recommendation of the enrollment appropriateness to the HOME Choice Unit in Columbus.
Making referrals to HCBS waiver programs as necessary and other community services and supports.
Advocating on behalf of a client for other services and benefits in the community, making referrals to Adult Protective Services and applicable authorities to ensure health and safety of the consumer.
Ensuring timely reporting to all mandated agencies as per Ohio law.
Maintaining working knowledge of Medicare, Medicaid and third-party reimbursement and Community service delivery systems with the ability to link consumers to community resources.
Reviewing PASRR, and UPAR compliance and determinations for long term care applicants.
Processing PAS/ID, LOC and UPAR determinations per Ohio Administrative Code and Department of Job and Family Services standards.
Determining Level of Care (LOC) requests received from Nursing facilities and Hospital’s.
Assigning delayed assessment per ODA rule based on PAR determination so a face-to-face assessment may be completed.
Providing Pre-Admission Review technical assistance
Evaluating PAS/ID, Level of Care (LOC) and UPAR requests.
Making Community referrals as needed
Performing other duties as assigned by immediate supervisor and/or management team.