Position Summary:
The Intake Nurse conducts enrollment assessments to determine clinical eligibility for the Managed Long-Term Care Plan (MLTCP) by:
- conducting functional assessments of clients in the home
- Preparing assessment documents and developing initial plans of care.
Must speak FLUENT English and Spanish. Frequently communicates complex information and interacts through electronic documentation/tools. This is a paperless work environment requiring daily hands-on administration of multiple electronic Patient Health Information (PHI) databases and security requirement tools such as encryption. These systems include, but are not limited to CCMS (CareEnhance Clinical Management Software), Sunguard Macess Service Module (electronic archiving), RightFax, VoIP, Virtual Work Platforms (using VPN), scanning and creating .pdf files (Adobe Acrobat), and MS Office 2010 software (such as Word and Outlook).
Essential Duties and Responsibilities:
- Conducts enrollment assessments of prospective members in their homes; makes enrollment decisions and develops initial plans of care by utilizing clinical expertise and critical thinking skills.
- Determines clinical eligibility of prospective members following guidelines of MLTCP regulations.
- Completes required paperwork and documentation needed to fulfill enrollment requirements of NYSDOH and care management teams using demonstrated ability to develop assessments into written reports. Enters documentation/PHI in various electronic systems including EMR, DELTA, Macess, Right Fax.
- Communicates with families, caregivers, physicians and community providers regarding MLTCP services and service plans, required documents, coordinated home visits as needed. Ensures that prospective members and significant others/responsible parties understand and are in agreement with enrollment in managed long term care.
Other Duties and Responsibilities:
- Represents MLTCP in the community and supports education of community providers, families and prospective enrollees in MLTCP services. Assists in developing innovative methods of documentation and record-keeping.
- Conducts assessments in settings other than home (skilled nursing facilities) as needed.
Work Experience/Qualifications:
1-3 years
Language Requirements:
Must speak FLUENT English and Spanish.
Education Requirements:
Associates Degree; NYS Registered Professional Nurse.
Technical Skills:
Intermediate Microsoft Office 2010, Electronic Medical Records, Use of Databases (PHI) and Electronic Archiving and Faxing.
A minimum of one year of U.S. based field work experience of which at least one year is in one of the following areas:
- Geriatrics
- Home Care
- Discharge Planning
- Case Management
- Medical Surgical Nursing
- Must be able to determine clinical eligibility, navigate health care systems, organize daily activities and visits, coordinate daily work with enrollment specialists, and problem-solve difficult/challenging cases.
- Experience managing patient/client information in a shared network environment using paperless database modules and archival systems.
- Experience must include demonstrated ability to determine appropriate plans of care for frail elderly clients, negotiate initial service plans so that clients and families are in agreement, identify appropriate services that are needed.
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