In-Home RN Case Manager: HRA, MDS & LTSS Assessments

Fallon Health; Worcester (MA); Hybrid; USD 79,000 - 83,000; Full time

Job summary

Fallon Health seeks an experienced Assessment Nurse Case Manager to perform in-home Health Risk Assessments (HRAs) and MDS/UCA submissions for new enrollees, with some visits conducted telephonically.

You will onboard members within 30 days, interact with the care team, educate on NaviCare, and coordinate LTSS evaluations while maintaining regulatory compliance and high-quality outcomes.

Qualifications

• Graduate from an accredited school of nursing is mandatory; BSN or higher preferred.
• Active, unrestricted MA RN license.
• Certification in Case Management strongly desired.
• Experience with in-person and telehealth assessments.

Responsibilities

• Conducts home visits for onboarding and regulatory assessments.
• Completes HRAs and PCA assessments.
• Submits MDS assessments.
• Provides education on NaviCare case management program.
• Conducts telephonic assessments when appropriate.
• Collaborates with Care Team.
• Completes LTSS evaluations and collaborates with UM.

Skills

Interdisciplinary teamwork

Communication skills

Assessment skills

Clinical RN experience

Education

BSN or higher

Job description

Fallon Health seeks an experienced Assessment Nurse Case Manager to perform in-home Health Risk Assessments (HRAs) and MDS/UCA submissions for new enrollees, with some visits conducted telephonically.

You will onboard members within 30 days, interact with the care team, educate on NaviCare, and coordinate LTSS evaluations while maintaining regulatory compliance and high-quality outcomes.