Assessment Nurse, Hybrid NY

Job Ref: 120924 Category: Utilization Review and Case Management Department: MANAGED LONG TERM CARE Location: 50 Water Street, 7th Floor, New York, NY 10004 Job Type: Regular Employment Type: Full-Time Hire In Rate: $108,815.00 Salary Range: $108,815.00 - $108,815.00 Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day. About NYC Health + Hospitals MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlusHealth has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life. Position Overview: Empower. Unite. Care. MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day. The Assessment Nurse may be the first person that the potential member/member and family meet from the MLTCP programs. The Assessment Nurse conducts the UAS assessment to determine the level of care needed to support applicants/members in their own homes. The Assessment Nurse also completes the UAS assessment tool on members already enrolled in the MLTC programs upon program enrollment, semi-annually and when there is a significant change in condition.

Job Description

• Meets with applicant, family, and caregiver in person to determine if MLTC program applicants meet the clinical qualifications for enrollment. (i.e., UAS score 5 or greater, needing 120 days of care, safe in-home environment).
• Meets with member, family, and caregiver in person to conduct the UAS tool for MLTC program enrollees or prospective enrollees.
• Documents outreach attempts in care management data system.(i.e. Bookings platform)
• Conducts a minimum of 13 UAS assessments on a weekly basis which may include initials, significant change in condition, return assessments and/or semi-annual/re- assessments; at least 60% of them should be in-person.
• Extracts information from the member as well as from other sources such as DCMS and other quality reports as needed to complete the UAS.
• Conducts “pop-up/drive-by” visits for members/applicants who are unable to reach via phone or family member; these visits are scheduled around the expected minimum UAS assessment per week and will not change the completion rate expectations.
• Completes the Task Based Tool from the Lenavi, and after clinical review the Assessment Nurse shares potential hours and services with applicant and family.
• Discusses other options for applicants that do not meet the clinical qualifications for the MLTCP.
• Reviews handbook and enrollment documents with applicants who meet the criteria for enrollment in the MLTCP. ARNS will obtain electronic signatures for all new enrollment visits they conduct. And will respond to questions and obtain wet or electronic signature on all necessary documents.
• Reviews findings of assessments with Team Lead after interview with applicant and family member.
• Conducts reassessments in-person of member pursuant to schedule and in cases when Care Manager request re-assessment due to change in condition of the member.
• Participates in MetroPlusHealth quality management activities related to MLTC as needed.
• Provides information to the MLTC management teams
• Performs other tasks assigned by the MLTC management teams

Minimum Qualifications

• Bachelor’s Degree required
• A minimum of two (2) to three (3) years clinical experience in Certified Home Health Agency (CHHA), Lombardi program and MLTC experience.
• Registered Nurse, Currently New York State license.
• UAS Certified RN required.

Professional Competencies

• Integrity and Trust
• Customer Service Focus
• Basic working knowledge of computer systems
• Excellent communications, written and analytical skills

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