Field Registered Nurse

• Complete medical and/or behavioral health assessments within contract requirements
• Conduct on-site, video call, and/or telephonic assessments to determine individuals’ needs, eligibility, level of care, or related outcomes
• Conduct comprehensive in-person assessments in members’ homes, hospitals, and other community settings
• Use standardized tools (UCA, TTT) to identify medical, functional, and social needs
• Develop and manage service plans for complex or high-acuity members
• Coordinate with healthcare providers, case managers, community resources, and care teams
• Evaluate eligibility for referrals to other professionals or agencies
• Revise care plans as members’ needs change and align them with member goals
• Educate members, families, and caregivers on available services and options
• Document assessments and care activities accurately for billing, compliance, and quality reporting
• Maintain compliance with state and federal regulations, Medicaid/LTSS program guidelines, HIPAA, and company confidentiality policies
• Advocate for members to remain in preferred living environments and maintain independence
• Travel as required by program contract requirements
• Perform other related duties as assigned

• Current, active, unencumbered Registered Nurse (RN) license valid in Massachusetts
• High School Degree or equivalent
• Minimum 2 years of relevant post-graduate clinical experience as a Registered Nurse
• Experience working with vulnerable populations, including people with behavioral health needs, intellectual and developmental disabilities (I/DD), and long-term services and supports (LTSS) needs
• Experience conducting clinical or functional assessments in home or community-based settings
• Knowledge of community-based services, care coordination, and person-centered care planning
• Familiarity with Mass Health programs, LTSS, and Home and Community-Based Services (HCBS) waiver programs
• Proficiency in Microsoft Office applications
• Experience documenting assessments in electronic systems
• Ability to perform duties in compliance with Person First standards, HIPAA guidelines, and company confidentiality policies and procedures
• Reliable high-speed internet service
• Minimum 20 Mbps download speed and 50 Mbps for shared internet connectivity
• Minimum 5 Mbps upload speed
• Private and secure workspace

Demonstrates expertise in conducting comprehensive medical and behavioral health assessments, developing service plans, and coordinating care for vulnerable populations. Proficient in compliance with state and federal regulations, including HIPAA and Medicaid guidelines.

• Registered Nurse (RN) License
• Clinical Assessment Experience
• Care Coordination
• Knowledge of Mass Health Programs
• Proficiency in Microsoft Office

• Medical Assessments
• Behavioral Health Assessments
• Service Plan Development
• Care Plan Revision
• Documentation in Electronic Systems

• Advocacy
• Communication
• Education

• Registered Nurse (RN) License

• Long-Term Services and Supports (LTSS)
• Home and Community-Based Services (HCBS)
• Person-Centered Care Planning
• Compliance with HIPAA
• Community-Based Services

• Standardized Assessment Tools (UCA, TTT)
• Electronic Documentation Systems