Intake RN

Centers Plan for Healthy Living; Florida; Remote; USD 70,000 - 100,000; Full time

Job summary

Centers Plan for Healthy Living is seeking an Intake RN to conduct UAS-NY assessments and determine membership eligibility. The role involves developing care plans for prospective members and explaining long-term care benefits to prospects.

The RN will coordinate with supervisors and UAS reviewers, ensure timely documentation, and participate in quality improvement activities while maintaining HIPAA confidentiality.

Qualifications

• RN license required
• Solid clinical judgment and real-time problem solving
• Ability to communicate clearly and educate prospects

Responsibilities

• Assess prospects via telehealth using UASNY to determine eligibility and initial plan of care
• Develop plans of care for prospects using NYIA assessments
• Complete required assessment forms and documentation within deadlines
• Explain managed long term care benefits and services to prospects
• Escalate issues to supervisors as needed

Job description

JOB SUMMARY:

The Intake RN is responsible for conducting UAS-NY assessments, determining when individuals are appropriate for membership and developing plans of cares for prospective CPHL members. Intake RNs must complete full productivity and submit all paperwork in a timely fashion. This position is also responsible for explaining managed long term care benefits and services to prospects. The Intake RN will be in constant communication with their Intake RN Supervisor as well as Intake UAS reviewers to ensure that documentation is being completed properly.

PRIMARY RESPONSIBILITIES:

• Assesses prospects via telehealth, completing a comprehensive assessment (UASNY) to determine eligibility and initial plan of care
• Develops plans of cares for prospects using NYIA’s assessments
• Effectively completes the required assessment form (UASNY) and other CPHL necessary documents within the required timeframes and in accordance with CHPL established policies and procedures and State and Federal guidelines and regulations.
• Communicates plan benefits clearly and easily to prospects and referral sources
• Completes and submits thorough and high-quality documentation in a timely manner
• Appropriately alerts Supervisors regarding any issues encountered during an assessment
• Recognizes quality of care issues and escalates issues appropriately, communicating effectively with coordinators and supervisors as needed
• Complies with all CPHL’s standards for documentation.
• Maintains member confidentiality and compliance with HIPAA requirement.
• Participates in regularly scheduled and other staff meetings as requested
• Participates in quality improvement initiatives
• Other duties as assigned

EDUCATION AND EXPERIENCE:

Education Required:
Registered Nursing License

Type of Experience

Preferred:
Overall understanding of community-based care programs

Specific Technical Skills

Preferred:
Case Trakker, SalesForce, Excel, Power Point, Word

Certifications/Licensure:

Required: Registered Nursing License

Knowledge and Skills:

Solid clinical judgment and ability to problem solve in real-time

• Knowledge of MLTCP regulations
• Works well with various personalities and work styles
• Ability to manage multiple tasks simultaneously and meets deadlines
• Ability to communicate clearly, educate prospects, and take ownership of assigned work

PHYSICAL REQUIREMENTS:

The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Must be able to operate office equipment including a computer and phones
• Able to communicate both in person and by phone

The above statements are intended to describe the general nature and level of work performed by individuals assigned to the job classification. They should not be construed as an exhaustive list of all responsibilities, duties and skills required.