UAS Case Manger

SmartRecruiters, Inc.; New York (NY); On-site; USD 65,000 - 80,000; Full time

Job summary

Integrated Resources, Inc. seeks a UAS Assessor to perform initial assessments and re-assessments in the field, complete enrollment paperwork, and manage the tasking tool. Travel to multiple NYC area locations is required, with flexibility in hours.

The role emphasizes accuracy, adherence to NY State guidelines, and ongoing training to ensure quality enrollment processes for consumers in managed care settings.

Qualifications

• Minimum 5 years clinical experience with focus in managed care, including behavioral health disease or case management.
• RN licensure (State and/or Compact) is required.
• Knowledge of Milliman Care Guidelines and other evidence-based clinical guidelines.

Responsibilities

• Complete UAS initial and/or reassessment documentation and enrollment materials in the consumer's home.
• Attend training sessions and continuing education on UAS documentation and tasking tool.
• Support quality and performance improvement initiatives and related reviews.

Skills

UAS Assessor experience

Job description

Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.

Job Description

Description:

• Responsible for the completion of 1) UAS Initial Assessments and Reassessments based on NY State requirements and guidelines and training provided by Client and/or outside resources.
• 2) Enrollment paperwork materials required to appropriately process consumer’s application for enrollment.
• 3) UAS Tasking Tool based on guidelines and training provided by Client and/or outside resources. Responsible for correction and revision of UAS, paperwork, and tasking tool documentation based on review and feedback provided through quality and associated review processes.

ESSENTIAL FUNCTIONS:

• Complete UAS Initial and/or Reassessment documentation, enrollment paperwork, and tasking tool in the consumer’s home.
• Attend training and continuing education sessions and lessons focused on the proper completion of UAS documentation, enrollment paperwork, and tasking tool.
• Focus on continuous improvement and quality excellence in the completion of all material associated with the initial enrollment/continued enrollment of consumers as members in the plan.
• Supports initiatives of the Quality Assessment and Performance Improvement Committee.
• All other duties as assigned.

Requirements/Certifications:

• The hiring manager is looking for English or Bi-lingual Spanish or Russian candidates.
• UAS Assessor experience is a MUST!!!

This is a traveling position at a rate of $.54/mile. The selected candidates will travel to Brooklyn, Queens, The Bronx, Manhatten, and West Chester. On very few occasions, the candidate may have to travel between two cities on one day, but that is not likely. The position is M-F with the typical hours of 9am - 5pm; however there is some flexibility with the hours.

Qualifications

Minimum 5 years clinical experience with focus in managed care, including behavioral health disease or case management.

• Care Mgmt.\RN - Registered Nurse, State and/or Compact State Licensure
• Understands and is able to apply principals of Care Management and Person Centered Service Planning.
• Is able to apply Millimen Care Guidelines and other applicable, evidenced-based clinical guidelines.
• Is able to understand and apply coverage guidelines and benefit limitations.
• Familiar with clinical needs and disease processes for chronic physical and behavioral illnesses (depression, challenging behaviors, Alzheimer’s disease and other disease-related dementias).
• Understands and adapts appropriately to issues related to communication, cognitive or other barriers.

Additional Information

Integrated Resources, Inc.

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