One of New York’s largest not-for-profit health insurers offering over 2 million members access to high-quality, affordable healthcare is seeking Registered Nurses (RN) to join their team. Their goal is to help members navigate the healthcare system and foster healthier communities by partnering with providers and community organizations to advance health equity and value-based care.
Position Overview:
Conducts home and virtual assessments 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.
Key Responsibilities:
Conducts two-member home assessments daily 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
Navigates multiple technology/digital platforms such as UAS software, electronic medical records, TruCare, to conduct and document comprehensive assessments accurately and efficiently
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 Care Managment Team; 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 agree with enrollment in a managed long-term care plan
Additional duties as assigned
Requirements:
New York State RN license
ASN or BSN degree
Ability to travel for field nursing to selected boroughs via public transportation or vehicle with a NYS Driver's License
Must be comfortable going into NYCHA housing, nursing home, shelter and projects
Must have a great understanding of the chronic health conditions (hypertension, diabetes, respiratory issues and COPD) with the population
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
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
RN Grads and experienced RNs with prior experience as a HHA, Personal Care Aide (PCA), PCT, EMT, or Social Workers are an excellent match for Field Assessment Nurse and Hybrid Assessment RN roles
Prior work experience requiring technological proficiency including the ability to navigate multiple technology platforms and modalities - MS applications, Excel especially, Outlook calendar, Zoom and Teams
Work experience preferred in one or more of the following areas: geriatrics, home care, discharge planning, case management, and/or medical surgical nursing
Knowledge of health insurance, Medicaid, Medicare and MLTCP
Time management, critical/creative thinking, communication, and problem-solving skills
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