Temp to Perm SCO Assessment Nurse Case Manager - Lowell - up to 6 months

Fallon Health; Massachusetts; On-site; USD 79,000 - 83,000; Full time

Job summary

Fallon Health is seeking an experienced Assessment Nurse Case Manager in Massachusetts. The role involves performing face-to-face home visits for onboarding, conducting Health Risk Assessments, and managing MDS submissions for new enrollees.

The position supports LTSS programs and collaborates with interdisciplinary teams, with some telehealth as needed. Qualified candidates hold an active MA RN license, a BSN or higher, and ideally Case Management certification.

Qualifications

• RN with active MA license and clinical nursing experience.
• BSN or higher in nursing or health-related field preferred.
• Certification in Case Management desired.

Responsibilities

• Conducts in-home onboarding and regulatory assessments.
• Completes HRAs, PCA assessments, and submits MDS assessments.
• Provides education on NaviCare case management program.
• Performs telephonic/virtual assessments when appropriate.
• Collaborates with care team and UM for LTSS evaluations.

Skills

RN clinical experience

Communication skills

Team collaboration

Interviews & assessment

Education

BSN or higher

Tools

MDS/OASIS familiarity

Telehealth platforms

Job description

Temp to Perm SCO Assessment Nurse Case Manager - Lowell - up to 6 months

Location: US-MA-Worcester, MA

Overview

This is Temp to Perm for an experienced Assessment NCM doing HRA's and MDS/UCA's in the Lowell area.

About us: Fallon Health is a company that cares. We prioritize our members-always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon Health delivers equitable, high-quality, coordinated care and is continually rated among the nation's top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)- in the region. Learn more at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn.

Brief summary of purpose: The Assessment Nurse Case Manager completes face-to-face home visits for new enrollees within 30 days of enrollment to onboard and completes regulatory assessments. The Assessment Nurse Case Manager completes in person Health Risk Assessments (HRAs) in accordance with members assigned frequency. The Assessment Nurse Case Manager completes all new Personal Care Attendant (PCA) Assessments using the integrated time for task tool and well as yearly PCA reevaluations. The Assessment Nurse Case Manager is also responsible for the timely and accurate submission of yearly (and when there is a significant change in status) MDS assessments. Assessments are done primarily in person but may at times be completed telephonically.

Responsibilities

Overview

• 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.

Member Assessment, Education & Advocacy

• Conducts in-home assessments with motivational and culturally sensitive interviewing.
• Performs medication reconciliation.
• Completes State-required assessment tools per contract.
• Conducts functional assessments for LTSS programs.
• Participates in training and audits.
• Completes telephonic/virtual assessments.
• Maintains program/policy knowledge to educate members.
• Supports HEDIS, Medicare 5 Star, and other initiatives.

Qualifications

Education: Graduate from an accredited school of nursing mandatory and a Bachelors (or advanced) degree in nursing or a health care related field preferred.

License: Active, unrestricted license as a Registered Nurse in Massachusetts.

Certification: Certification in Case Management strongly desired.

Other: Driving your personal motor vehicle is an essential job function of this position and the following requirements apply:

• Must possess a valid drivers' license
• Must attest to no disqualifiers per Driver Safety Policy
• Must possess and provide proof of minimal state required auto insurance
• Must have reliable transportation

Experience:

• 1+ years of clinical RN experience with complex medical, behavioral, and social co-morbidities.
• Ability to conduct assessments in-person and telehealth.
• Ability to work on interdisciplinary teams.
• Skill in screening social determinants of health.
• Strong communication and interviewing skills.
• Problem-solving skills and adaptability.
• Knowledge or willingness to learn regulatory requirements.
• Preferred experience: Home Health, OASIS/MDS, Medicare/Medicaid, face-to-face member interactions.
• Reliable home internet.

Pay Range Disclosure: In accordance with the Massachusetts Wage Transparency Act, the pay range for this TEMPORARY position is around $57 - $60/hour which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate's experience, skills, and fit with the role's responsibilities.

Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.