Registered Nurse

Job Description

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.

This position is member facing and requires visits to members at their home or facility.

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.

• Performs daily local travel in the assigned local territories (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.

• Must reside in the state of New York or neighboring states (NJ, CT, parts of PA). Must have a NY state government .

• 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.

• Ability to commute as needed to meet with members in person at their home or facility.

To all current Molina employees:
If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $24 - $56.17 / HOURLY

* Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.