RN Supervisor, SCO program on the Assessment team Worcester & Western MA

Overview

About us:

Fallon Health is a company that cares. We prioritize our members-always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon Health delivers equitable, high-quality, coordinated care and is continually rated among the nation's top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)- in the region. Learn more at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn.

Brief summary or purpose:

The RN Assessment Supervisor is responsible for:

• Lead a multi‑site RN team to ensure timely, high‑quality assessments and care coordination.
• Ensure all assessments are completed accurately, efficiently, and on schedule.
• Provide coaching, supervision, and training; implement remediation when needed.
• Work with navigators and care teams to support comprehensive member care.
• Partner with Clinical Integration Leaders to implement required Models of Care and program standards.
• Monitor team performance, ensure compliance, and maintain staff readiness.
• Support quality improvement efforts tied to NCQA, HEDIS, CMS, State, and other performance measures.
• Prepare and organize case files for audits and regulatory reviews.
• Build collaborative relationships with State agencies and community providers to support coordinated services.

Responsibilities

Primary Job Responsibilities:

Primary Goals

• Ensure timely, accurate assessments for members.
• Maintain high team performance, productivity, and compliance.
• Support quality, regulatory, and program standards.
• Strengthen collaboration across internal teams and community partners.

Key Tasks

Team Leadership & Oversight

• Lead a multi-site RN team and ensure assessments are completed correctly and on schedule.
• Hire, train, coach, and evaluate staff; address performance issues when needed.
• Monitor workloads, reassign tasks, and ensure team readiness.
• Hold regular 1:1s, huddles, and case discussions.
• Audit documentation for accuracy and adherence to workflows.

Assessment & Program Management

• Ensure proper use of all assessment tools (MDS HC, UAT, product-specific tools).
• Serve as subject matter expert for MDS submissions and PCA time-for-task guidelines.
• Ensure accurate member rating category assignments.
• Guide staff in whole-person care planning (medical, behavioral, social).

Quality & Compliance

• Support quality initiatives (NCQA, HEDIS, CMS Stars, State measures).
• Use reporting tools to track performance; teach staff to use reports independently.
• Prepare assessment cases and documentation for audits and regulatory reviews.
• Ensure strict HIPAA compliance.

Collaboration & External Relationships

• Work closely with navigators, care managers, and integration leaders.
• Support Models of Care and program requirements across product lines.
• Maintain partnerships with state agencies and community providers.
• Share information on clinical, social, and financial resources.

Additional Responsibilities

• Provide support and coverage within the department as needed.
• Complete other tasks assigned by the Manager/Director.

Qualifications

Qualification Requirements

Education

Graduate from an accredited school of nursing, associates degree required, bachelor's or higher strongly preferred

License/Certifications

License: RN Candidates (Required) Active, unrestricted license as a Registered Nurse in Massachusetts

Certification: Certification in Case Management strongly desired, willingness to obtain when eligible

Other: Driving your personal motor vehicle is an essential job function of this position and the following requirements apply:

• Must possess a valid drivers' 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

Experience

• 4+ years RN clinical experience managing patients with complex medical, behavioral, and social needs.
• Strong customer service skills and ability to resolve issues quickly.
• Experience with process improvement and using data to enhance workflows (preferred).
• Excellent organization and multitasking abilities.
• Knowledge of community resources, levels of care, and developing care plans that meet regulatory standards.
• Able to adapt to changing needs, think creatively, and solve problems.
• Experience supervising staff supporting social determinants of health needs (preferred).
• Experience with OASIS and/or MDS assessments (preferred).
• Familiarity with Medicare and Medicaid programs and regulations (preferred).
• Background in social service agencies or related state agencies (DMH, DDS, DCF, DYS) or community service organizations (preferred).

Pay Range Disclosure:

In accordance with the Massachusetts Wage Transparency Act, the pay range for this position is $118,000 - $125,000 annually, which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate's experience, skills, and fit with the role's responsibilities.

Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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