Home-Based Nurse Case Manager — LTSS & MDS Focus

Fallon Community Health Plan, Inc.; Lowell, Northern (MA, KY); Hybrid; USD 95,000 - 100,000; Full time

Job summary

Fallon Health is seeking an Assessment Nurse Case Manager in Massachusetts to perform in-home onboarding and regulatory assessments for new enrollees. You will complete HRAs, PCA assessments, and MDS submissions, providing education on NaviCare case management and collaborating with care teams.

The role supports telephonic assessments when appropriate, participates in LTSS evaluations, and requires RN licensure in MA with strong communication and adaptability.

Qualifications

• Graduate of an accredited nursing program.
• Active Massachusetts RN license required.
• Certification in Case Management strongly desired.
• Experience with home health, OASIS/MDS, Medicare/Medicaid preferred.

Responsibilities

• Conducts in-home onboarding and regulatory assessments.
• Performs Health Risk Assessments (HRAs) and PCA assessments.
• Submits MDS assessments.
• Provides education on NaviCare case management program.
• Conducts telephonic assessments when appropriate.
• Collaborates with Care Team and UM.
• Completes LTSS evaluations and participates in audits.

Skills

RN clinical experience

Interdisciplinary teamwork

In-person assessments

Telehealth assessments

Education

Bachelor's degree in nursing

Job description

Fallon Health is seeking an Assessment Nurse Case Manager in Massachusetts to perform in-home onboarding and regulatory assessments for new enrollees. You will complete HRAs, PCA assessments, and MDS submissions, providing education on NaviCare case management and collaborating with care teams.

The role supports telephonic assessments when appropriate, participates in LTSS evaluations, and requires RN licensure in MA with strong communication and adaptability.