(RN)Uniform System Assessor Nurse (NYC Local Travel Required)
Molina Healthcare, New York, NY, United States
Job Summary
Provides support for the completion of the Community Health Assessment (CHA) - formerly the UAS (Uniform Assessment System), initial assessments and reassessments based on New York state requirements, guidelines, and training provided by the company and/or outside resources. Completes enrollment paperwork materials required to appropriately process member applications for enrollment and CHA tasking tool in alignment with guidelines and training provided by the company and/or outside resources. Facilitates correction and revision of CHA paperwork and tasking tool documentation based on review and feedback provided through quality/review process.
Job Duties
Completes approved New York State initial assessment tool and/or clinical reassessment used to define eligibility for community-based long-term care services for members.
Completes enrollment paperwork, progress notes and tasking tool in member homes to assist in determining eligibility for services; reviews all data collected for accuracy and completion prior to submission.
Charts all contacts and findings within appropriate tool and form per policy and procedure and within established deadlines.
Attends training and continuing education sessions focused on the proper completion of Comprehensive Health Assessment (CHA) documentation, enrollment paperwork, and tasking tool.
Focuses on continuous improvement and quality excellence in the completion of all materials associated with the initial enrollment/continued enrollment of members in the plan.
Supports initiatives of the quality assessment and performance improvement committee.
25- 40% estimated local travel may be required (based upon state/contractual requirements).
Job Qualifications
Required Qualification:
At least two years of clinical experience in managed care - including case management and home visit experience, or equivalent combination of relevant education and experience.
Registered Nurse (RN). License must be active and unrestricted in state of practice (NY).
Must reside in the state of New York or neighboring states (NJ, CT, parts of PA). Must have a NY state government ID.
Trained and knowledgeable in the New York Uniform Assessment System (UAS).
Must be able to travel to multiple boroughs via car or commuting public transportation.
Understands and applies principles of care management and person-centered planning.
Solid assessment skills.
Understands and applies coverage guidelines and benefit limitations.
Familiar with clinical needs and disease processes for chronic physical and behavioral illnesses.
Understands and adapts appropriately to issues related to member communication, cognitive or other barriers.
Organizational skills, and ability to prioritize and follow through on multiple projects in a timely manner.
Effective verbal and written communication skills.
Microsoft Office suite and applicable software programs proficiency.
Preferred Qualification:
Certified Case Manager (CCM) or Chronic Care Professional (CCP).
Home care or long-term care experience.
Community support service experience accessing and using durable medical equipment (DME).
Experience in utilization review, concurrent review and/or risk management.
Bilingual or multi-lingual in Chinese (Mandarin or Cantonese), or Spanish.
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Provides support for the completion of the Community Health Assessment (CHA) - formerly the UAS (Uniform Assessment System), initial assessments and reassessments based on New York state requirements, guidelines, and training provided by the company and/or outside resources. Completes enrollment paperwork materials required to appropriately process member applications for enrollment and CHA tasking tool in alignment with guidelines and training provided by the company and/or outside resources. Facilitates correction and revision of CHA paperwork and tasking tool documentation based on review and feedback provided through quality/review process.
Job Duties
Completes approved New York State initial assessment tool and/or clinical reassessment used to define eligibility for community-based long-term care services for members.
Completes enrollment paperwork, progress notes and tasking tool in member homes to assist in determining eligibility for services; reviews all data collected for accuracy and completion prior to submission.
Charts all contacts and findings within appropriate tool and form per policy and procedure and within established deadlines.
Attends training and continuing education sessions focused on the proper completion of Comprehensive Health Assessment (CHA) documentation, enrollment paperwork, and tasking tool.
Focuses on continuous improvement and quality excellence in the completion of all materials associated with the initial enrollment/continued enrollment of members in the plan.
Supports initiatives of the quality assessment and performance improvement committee.
25- 40% estimated local travel may be required (based upon state/contractual requirements).
Job Qualifications
Required Qualification:
At least two years of clinical experience in managed care - including case management and home visit experience, or equivalent combination of relevant education and experience.
Registered Nurse (RN). License must be active and unrestricted in state of practice (NY).
Must reside in the state of New York or neighboring states (NJ, CT, parts of PA). Must have a NY state government ID.
Trained and knowledgeable in the New York Uniform Assessment System (UAS).
Must be able to travel to multiple boroughs via car or commuting public transportation.
Understands and applies principles of care management and person-centered planning.
Solid assessment skills.
Understands and applies coverage guidelines and benefit limitations.
Familiar with clinical needs and disease processes for chronic physical and behavioral illnesses.
Understands and adapts appropriately to issues related to member communication, cognitive or other barriers.
Organizational skills, and ability to prioritize and follow through on multiple projects in a timely manner.
Effective verbal and written communication skills.
Microsoft Office suite and applicable software programs proficiency.
Preferred Qualification:
Certified Case Manager (CCM) or Chronic Care Professional (CCP).
Home care or long-term care experience.
Community support service experience accessing and using durable medical equipment (DME).
Experience in utilization review, concurrent review and/or risk management.
Bilingual or multi-lingual in Chinese (Mandarin or Cantonese), or Spanish.
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