Clinical Registered Nurse (RN) - Home Health Assessments

Position Overview

We are seeking a dedicated Registered Nurse (RN) to join our team. In this role, you will be responsible for conducting thorough assessments to ensure high-quality care for our consumers. Your tasks will involve reviewing determinations, resolving technical issues, and collaborating with an interdisciplinary care team to effectively support our community.

Key Responsibilities

• Review favorable and partially favorable determinations in accordance with applicable regulations.
• Make medical necessity determinations for assigned cases.
• Address technical issues related to reconsiderations.
• Assess and summarize facts from assigned cases or sites, identifying any relevant issues.
• Participate in special projects, including general legal and medical research, drafting proposal sections, or serving as a liaison for specific initiatives as needed.
• Conduct initial assessments of consumers, evaluating health status, functional capabilities, strengths, care needs, and personal preferences.
• Review consumer medical documentation and health referral forms pertinent to the case.
• Enter assessment data into the UAS-NY online application and transmit it as required.
• Accurately code UAS assessments based on training and guidelines from the UAS-NY Community Health Assessment Reference Manual.
• Document outcomes from calls with consumers and track scheduled appointments.
• Stay updated on regulatory and project changes that impact the quality and validity of assessments.
• Foster effective communication and collaborative relationships with leadership and care team members to facilitate service delivery.
• Review non-qualified assessments with the Clinical Quality Assurance Department.
• Maintain a comprehensive understanding of community resources and network services for the target population.
• Perform other duties as assigned by the Regional Nurse Manager or project management team.
  
  

Minimum Qualifications

• Active RN license required.
• A minimum of 2 years of clinical experience as an RN.
• At least 2 years of experience in a home setting, including work with CHHAs, LHCAs, MLTC, or as a paraprofessional (e.g., HHA, LPN, or Private Duty Nursing).
• Valid RN license in the state of New York.
• Ability to travel within the assigned region, including visits to consumer homes.
• A valid New York State Driver's License or ID.
• Competence in conducting in-home health assessments across the assigned region.
• Proficiency in navigating web-based applications, Microsoft Outlook & Word, and conducting assessments via Zoom.
• Strong understanding of nursing theory, state, and agency regulations.
• Excellent organizational, interpersonal, and communication skills.
• Ability to work effectively with diverse consumer populations and demonstrate sensitivity in a fast-paced environment.
• Capacity to manage multiple complex tasks and work independently.
  
  

Home Office Requirements

• Candidates must have their own cell phone.
• Company-issued computer equipment will be provided.
• Reliable high-speed internet service is required, with minimum download speeds of 20 Mbps (50 Mbps for shared internet) and upload speeds of at least 5 Mbps.
  
  

Equal Opportunity Statement

We are proud to be an Affirmative Action/Equal Opportunity Employer, committed to creating a diverse and inclusive workforce. We welcome applications from active military service members, veterans, and their spouses, recognizing the unique skills and experiences they bring to our organization. Our commitment to diversity is a vital part of our mission to serve our community effectively.

Compensation

The annual base pay for this position ranges from \(95,000 to \)100,000, depending on experience and qualifications. We offer a comprehensive benefits package, including health insurance, life and disability insurance, a retirement savings plan, paid holidays, and paid time off.

Employment Type: Full-Time