SCO Assessment Nurse Case Manager - Westport
About The Position
The SCO Assessment Nurse Case Manager is responsible for completing face-to-face home visits for new enrollees within 30 days of enrollment to onboard and complete regulatory assessments. This role also involves completing in-person Health Risk Assessments (HRAs) according to assigned frequency, and completing all new Personal Care Attendant (PCA) Assessments using the integrated time for task tool, as well as yearly PCA reevaluations. Additionally, the Assessment Nurse Case Manager is 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. Fallon Health is a company that cares, prioritizing members and ensuring they receive the care they need and deserve. Founded in 1977, Fallon Health delivers equitable, high-quality, coordinated care and is consistently rated among the nation's top health plans. They embrace diversity and are committed to being a leading provider of government-sponsored health insurance programs in the region.
Requirements
- Graduate from an accredited school of nursing.
- Active, unrestricted license as a Registered Nurse in Massachusetts.
- Must possess a valid driver's 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.
- 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.
Nice To Haves
- Bachelors (or advanced) degree in nursing or a health care related field.
- Certification in Case Management.
- Home Health experience.
- OASIS/MDS experience.
- Medicare/Medicaid experience.
- Experience with face-to-face member interactions.
- Reliable home internet.
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
- Equal employment opportunities to all employees and applicants for employment.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
