RN, Home Health Assessments (No Weekends)

Activate Care•Holyoke, MA

2d•Remote

About The Position

Activate Care is dedicated to improving health equity and outcomes nationwide. Their platform, Care Link, facilitates care coordination for individuals with health-related social needs (HRSN). The Path Assist program uses a structured intervention to address HRSN, aiming to increase health confidence, self-efficacy, and reduce unnecessary healthcare spending. This community-focused Registered Nurse (RN) role involves traveling to members' homes across Massachusetts to conduct in-person health assessments for a managed care health plan's dually eligible members. The primary focus is on performing timely and accurate assessments, documenting findings, and then transferring the information to the health plan's care management team. This position is centered on assessment and documentation, not ongoing patient care management.

Requirements

Active Registered Nurse (RN) or higher licensure (e.g., Nurse Practitioner) in good standing with the Commonwealth of Massachusetts.
Associate of Science degree in nursing from an accredited program is required.
Valid driver's license, a personal vehicle, and verifiable insurance are required.
Minimum of 1 year of clinical experience in a home health setting.
Comfortable working independently in members' homes and managing a daily visit schedule.
Ability to document accurately and efficiently in an electronic platform via a secure virtual desktop.
Understanding of Medicare and Medicaid programs and the populations served.
Strong interpersonal and communication skills to engage members and families.
Ability to manage multiple assessments and priorities while maintaining attention to detail.
Awareness of and sensitivity to the diverse backgrounds and needs of the populations served.
Sound clinical judgment, decision-making, and problem-solving skills.
Basic proficiency with standard office and communication software.
Must reside within a commutable distance of the assigned Massachusetts territory, and generally within the territory served.
The role requires maintaining access to high-speed internet at home.
Influenza vaccination is required during flu season (October 1 through March 31) as a condition of employment.

Nice To Haves

BSN preferred.
Minimum of 1 year of experience completing assessments is preferred.
Prior experience with dual-eligible populations, Medicaid, or Medicare managed care is preferred.
Assessment-related certification (for example, RAC-CT) is preferred.

Responsibilities

Engage with members in their homes and other community settings to complete assessments, with mindfulness of the cultural and linguistic needs of each member.
Perform required assessments on a timely basis as assigned under the contract, including Uniform Core Assessments (UCA), Functional Assessments (FA), and Comprehensive Assessments, evaluating each member's physical, cognitive, and functional status.
Document assessments in the health plan's care management platform (GuidingCare) following the provided workflows and resource guides.
Send a SOAP note to the assigned health plan Care Manager upon assessment completion.
Submit accurate, complete documentation within 48 hours of each assessment and maintain a high completeness and quality standard as measured through the health plan's review and audit.
Complete required training and ongoing training to maintain system access.
Routinely travel to members' homes and/or community settings to conduct assessments.
Report abuse, neglect, or exploitation of older adults and adults with disabilities as a mandated reporter, as required by state law.
Follow field-safety practices for independent in-home visits and escalate clinical or safety concerns appropriately.
Adhere to all applicable regulatory, privacy (HIPAA), NCQA, and care management standards.
Maintain licensure and/or certifications.
Other duties as assigned.