MA - Intake Nurse

abby-care; Boston (MA); On-site; USD 75,000 - 95,000; Full time

Benefits offered by this job

Competitive compensation packages

Comprehensive health coverage

Generous paid time off

Financial savings benefits

Paid parental leave

Job summary

Abby-care is seeking an Intake Nurse in Boston who serves as the clinical gatekeeper for new referrals, ensuring compliance with payer, regulatory, and clinical eligibility requirements. This role requires a valid RN license and at least 5 years of nursing experience.

The Intake Nurse evaluates incoming referrals, clinical documentation, and collaborates with various teams to facilitate timely admissions. The position offers a competitive salary and comprehensive health benefits, in an environment driven by family-centric care.

Qualifications

• Active RN license in applicable state(s).
• Minimum 5 years of nursing experience.
• Minimum 1 year experience in home health, hospice, case management, or care coordination.
• Strong clinical assessment and critical thinking skills.
• Knowledge of Medicaid, Medicare, and home health regulations.
• Excellent verbal and written communication skills.
• Experience reviewing medical records and clinical documentation.
• Proficiency with EMR systems and Google Office.

Responsibilities

• Review incoming referrals for clinical appropriateness.
• Evaluate medical records and treatment plans.
• Determine if services meet admission criteria.
• Assess eligibility for various care services.
• Document qualification decisions.
• Conduct telephone-based clinical screenings.
• Gather clinical information needed for qualification.
• Verify requirements for Medicaid/Medicare.
• Collaborate with teams for admission coordination.

Skills

Clinical assessment

Critical thinking

Communication skills

EMR systems proficiency

Education

Active RN license

Minimum 5 years of nursing experience

1 year in home health or case management

Tools

Google Office

Job description

About Abby Care: Powering the future of care at home for all of America.

Abby Care is building the leading AI-native platform for family-led care.

America is facing a growing care crisis. Millions more people need care at home than ever.

Over 50 million family caregivers support loved ones without the tools, training, or recognition they deserve.

We believe families are the largest untapped caregiving workforce in America, and that technology can help them deliver better care while driving stronger outcomes and greater transparency across the healthcare system.

Abby Care combines clinical oversight with an AI-powered platform to train, enable, and support family caregivers in delivering high-quality care at home. Our platform helps health plans and government partners better understand, verify, and improve care in the home. We expand access to care, reduce reliance on higher-cost settings, and help ensure public dollars are spent effectively.

We are proud to partner with leading health plans, providers, and community organizations and are backed by top VCs. We envision a future where family-led care is a core part of the healthcare system. Abby Care is building that future.

Join us in solving one of the most important challenges of our time.

The Role

The Intake Nurse serves as the clinical gatekeeper for new referrals and prospective clients, ensuring patients meet payer, regulatory, agency, and clinical eligibility requirements before admission. This role collaborates closely with referral sources, family growth associates, case managers, business development teams, and clinical leadership to evaluate referrals, assess patient needs, determine service appropriateness, and support timely admissions.

The Intake RN uses clinical judgment to identify patients who qualify for skilled nursing, home health aide, personal care, paid family caregiver, or other agency services while ensuring compliance with state regulations, payer requirements, and agency policies.

This role reports directly to the Director of Nursing for the agency.

Key Responsibilities:

• Review incoming referrals, leads, and prospective patient inquiries for clinical appropriateness.
• Evaluate medical records, physician orders, diagnoses, medications, treatment plans, and supporting documentation.
• Determine whether requested services meet agency admission criteria and payer requirements.
• Assess eligibility for skilled nursing, personal care, home health aide/family caregiver, or specialty programs.
• Identify clinical risks, safety concerns, and service limitations that may impact admission.
• Escalate complex clinical cases to the Director of Nursing or Clinical Leadership as needed.
• Document qualification decisions and rationale for tracking purposes.

Clinical Lead Management

• Conduct telephone-based clinical screenings with patients, caregivers, referral sources, and physicians.
• Gather missing clinical information needed to complete qualification reviews.
• Verify functional limitations, care needs, diagnosis history, medication management needs, and caregiver support systems.
• Prioritize referrals based on urgency, acuity, and service availability.
• Maintain timely response times for all incoming leads.

Payer & Regulatory Compliance

• Verify referrals meet Medicare, Medicaid, managed care, private duty, and agency-specific requirements.
• Ensure physician documentation and orders support requested services.
• Maintain knowledge of state regulations, home health conditions of participation, and payer authorization requirements.
• Assist with prior authorization clinical documentation as needed.

Admission Coordination

• Collaborate with scheduling and operations teams to coordinate Start of Care (SOC) visits.
• Work with FGAs to communicate admission decisions to referral sources and internal stakeholders.
• Ensure all required documentation is completed prior to admission.
• Support smooth handoff to assigned case managers and field clinicians.

Quality & Process Improvement

• Monitor referral outcomes and identify trends affecting admissions.
• Participate in intake process improvement initiatives.
• Assist with development and maintenance of admission criteria and clinical screening tools.
• Support quality assurance audits related to intake documentation.

The Requirements:

• Active RN license in applicable state(s).
• Minimum 5 years of nursing experience.
• Minimum 1 year experience in home health, hospice, case management, utilization review, intake, or care coordination.
• Strong clinical assessment and critical thinking skills.
• Knowledge of Medicaid, Medicare, and home health regulations.
• Excellent verbal and written communication skills.
• Experience reviewing medical records and clinical documentation.
• Proficiency with EMR systems and Google Office.

Preferred

• Pediatric home health experience.
• Family caregiver program experience
• Prior authorization or utilization management experience.
• Bilingual capabilities.

Benefits:

• Competitive compensation packages that reflect the value you bring. We reward our team for the impact of their work – full-time employees are eligible for an annual company performance bonus.
• Comprehensive health coverage that works for you. Choose from high-quality medical dental and vision options, including a $0 deductible PPO and a company-funded HSA, alongside employer-paid life and disability insurance.
• Generous paid time off. We provide policies that allow you to recharge along with 10 paid company holidays.
• Financial savings benefits to support your future. We support your financial well-being with HSA contributions, optional FSA and commuter benefits, and full coverage of all 401(k) account fees (employer match not currently offered).
• Paid parental leave to support your growing family. We provide paid leave, so you can focus on bonding and adjusting to life as your family grows.

We are an equal opportunity employer and welcome applicants from all backgrounds, consistent with applicable laws. Employment is contingent upon successful completion of a background check, satisfactory references, and any required documentation.

Our Values

1. Families First Redefining healthcare starts with how we treat the parents and children we serve. We go above and beyond for every family, building strong, lasting relationships. We continually ask ourselves, "Would we want this for our own families?"
2. Urgency with Precision Millions of families are waiting for care, and they cannot wait, therefore this is not your typical 9 to 5 job. We match their urgency with our own, delivering exceptional care without compromise. Here, speed and excellence go hand in hand.
3. Relentlessly Resourceful As an ambitious startup, we adapt quickly and make the most of limited time and resources. We solve challenges with creativity to deliver results without unnecessary complexity.
4. Purpose with Positivity We take our mission seriously while never losing sight of the people behind the work. Respect, kindness, memes, and coffee make us stronger as a team and better for the families we serve.
5. Driven to Redefine What’s Possible We are here to make healthcare better, which means asking hard questions, challenging outdated systems, and finding smarter, more compassionate ways to deliver care.