The Assessment Nurse makes field assessment visits for members or prospective members around downstate New York at intervals required by the Department of Health (DOH) and completes appropriate documentation to determine members’ enrollment, service needs, and continued plan eligibility. This position coordinates with Care Management Team (CMT) to maintain efficient and effective operations of Healthfirst’s long term care plans such as CompleteCare and Senior Health Partners.
Duties and Responsibilities
- Conducts home assessments (and virtual assessments, as needed) for prospective members and re-assessments of current members using the Uniform Assessment System (UAS); make enrollment and continued eligibility determinations by utilizing clinical expertise and critical thinking skills. As needed, conducts assessments in settings other than home as needed, e.g. skilled nursing facilities or virtually
- Completes assessment of service needs per CMT and member's family/caregiver’s request to determine service needs or any necessary adjustments
- Reviews previous nursing assessments/medical notes to determine necessary adjustments/updates in Care Plan and/or to assist with nursing home admission
- Conducts in-person Care Management visits in support of person-centered service planning
- Liaisons between the member and the CMT; assesses home environment and psychosocial status
- Provides feedback to home care agencies and CMT regarding home care issues and contract nurses and aides performance
- Provides grass roots, community-based training for frail population care including self-care techniques and prevention strategies
- Ensures (prospective) members and significant others/responsible parties understand and are in agreement with enrollment in a managed long-term care plan
- Additional duties as assigned
Minimum Qualifications
- New York State RN license
- Valid New York State ID
- Ability to travel around downstate New York which includes the 5 boroughs, Long Island, Rockland, and Westchester.
- For PEDS positions only: 1 year of pediatric clinical field experience and/or experience with families and child serving systems, including child welfare and/or medically fragile/developmentally disabled populations
Preferred Qualifications
- Previous field-based experience assessing, planning, and evaluating member's care by making home or facility visits for intake/reassessments or start of care (SOC) Community Home Health Agency (CHHA) visits
- Work experience preferred in one or more of the following areas, geriatrics, home care, discharge planning, case management, and/or medical surgical nursing
- Work experience using electronic patient health information (PHI) database usage especially UAS
- NY state driver’s license
- Knowledge of health insurance, Medicaid, Medicare and MLTCP
- Experience working with a frail adult or elderly population with the ability to determine appropriate care plans and services for frail population as well as negotiate initial service plans so that members and families are in agreement
- Time management, critical/creative thinking, communication, and problem-solving skills
- Language preferences - Spanish, Russian, French, Creole, Mandarin, Cantonese
- Demonstrated ability handling heavy caseloads
- Intermediate Microsoft Word, Excel, and Outlook skills
Hiring Range*
As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.
In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.
*The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.