• Care Manager Reassessment Nurse- MLTC (All Boroughs)

    Job Locations US-NY-Staten Island
    ID 2018-1168
    Category
    Clinical- MLTC
    Type
    Regular Full-Time
  • Overview

    Responsible for reassessment of members by collaborating with caregivers and PCP.

    Responsibilities

    • Conducts comprehensive clinical, functional, psycho-social, and financial assessments of members to determine eligibility for continued participation in the MLTC program across         multiple regions.
    • Responsible for reassessing a minimum of 3 members per work day at locations throughout the Extended MLTC service area.
    • Responsible for scheduling and completing visits that are pre-assigned or added on as needed in a timely fashion.
    • Reassesses members’ health needs and continued eligibility for MLTC services
    • Develops members’ Service Plans in conjunction with the Care Management team, physicians, member and caregiver/s.
    • Conferences with Care Management team to assure appropriate services are in place.
    • Collaborates with Nurse Care Manager to create Person-Centered Plan of Care for each member to include various CBLT services, supplies, DME, environmental modification, etc.
    • Determines appropriate Personal Care service hours based on UAS assessment, DOH guidelines, and other appropriate tools and guidelines.
    • Submits complete and accurate written documentation on a timely basis in accordance with Plan policy.
    • Makes referrals for other services as needed.
    • Performs other care management activities as directed.
    • Maintains updated professional knowledge and participates in staff and member educational programs to ensure optimum quality of member care.
    • Stays abreast of current and potential changes to federal, state and local statutes and regulations and applicable quality assurance standards.
    • Adheres to MLTC Policies, rules and regulations.
    • Participates in special projects and performs other duties, as required.

    Qualifications

    • Current New York State License as Registered Nurse
    • One (1) year general Medical – Surgical Nursing experience required
    • Able to meet health standards of employment
    • Must successfully complete orientation
    • Prior home care experience preferred
    • UAS-NY assessment experience preferred

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