Healthfirst Assessment Registered Nurse (RN) in New York, New York
The Assessment Registered Nurse (RN)makes assessment visits at intervals required by the Department of Health (DOH) to determine enrollment, service needs and continued eligibility. This position coordinates with Care Management Team (CMT) to maintain a high level of efficient and effective individualized Care Management operations for SHP's managed long-term care plan (MLTCP), Healthfirst's Private Health Services Plan (PHSP), Complete Care, Fully Integrated Duals Advantage (FIDA) and Absolute Care.
Assessment Registered Nurse (RN)
Conduct enrollment assessments of prospective members and re-assessments of current members in their homes using the Uniform Assessment System (UAS); make enrollment decisions and continued eligibility determination by utilizing clinical expertise and critical thinking skills. As needed, will conduct assessments in settings other than home as needed, e.g. skilled nursing facilities
Complete assessment of service needs at the request of the Care Team, Member's Family/Caregiver to determine service level(s) or need to adjust Service levels
Complete Patient Review Instruments/Screens and all required nursing assessments for active members to determine adjustments/updates in Care Plan and/or to assist with nursing home admission.
Liaison between the member and the Care Management Team; assesses home environment and psychosocial status
Maintain a paperless work environment, which includes compiling assessment package requirements and electronic archiving using Macess Exp Service Module.
Other duties as assigned
Communicates with home care agencies and Care Management Team providing feedback regarding home care issues and the performance of Contract Nurses and Aides.
Provides grass roots, community-based training for frail population care including self-care techniques and prevention strategies.
Ensures that prospective members and significant others/responsible parties understand and are in agreement with enrollment in a managed long-term care plan.
New York State Registered Nurse (RN) license.
Ability to travel around downstate New York which includes the 5 boroughs, Long Island, and Westchester.
Work experience preferred in one or more of the following areas:
Medical Surgical Nursing
Work experience using electronic patient health information (PHI) database usage especially UAS
Unexpired NY state driver’s license or NYS ID
Knowledge of health insurance, Medicaid, Medicare and MLTCP
Experience working with a frail adult or elderly population with the ability to determine appropriate care plans and services for frail population as well as negotiate initial service plans so that members and families are in agreement
Time management, critical/creative thinking, communication, and problem-solving skills
Field experience assessing, planning, and evaluating member's/patient’s care
Language preferences - Spanish, Russian, French, Creole, Mandarin, Cantonese
Demonstrated ability handling heavy caseloads
Intermediate Microsoft Word, Excel, and Outlook skills
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.
If you have a disability under the Americans with Disability Act or a similar law, and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 1-212-801-6000. In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services.
EEO Law Poster and Supplement at https://www1.eeoc.gov/employers/poster.cfm
Healthfirst is a provider-sponsored health insurance company that serves more than 1.2 million members in downstate New York. With more than 4,000 employees, a network of nearly 30,000 providers, and revenues in excess of $8.6 billion, Healthfirst is one of the largest health plans in the New York City area.
Our members are our North Star, and our mission is guided by their needs and preferences in ensuring a superior experience and access to the highest quality healthcare when and where they need it. Healthfirst’s commitment to quality and member satisfaction has helped us earn top ratings for HMO health plans in New York City. We know that employees shape our company and connect us to our communities, and we look to recruit and retain intelligent, driven leaders who are passionate about healthcare and embody our five culture drivers:
Dream Big, Plan Wisely
Break Down the Walls
Think Critically, Speak Up, Deliver with Pride
Inspire Through Trust, Lead By Example