UAS Assessment Nurse - RCM Health Care Services : Job Details

Job Description

UAS Assessment Nurse (RN)$85k - $105k + $15,000 Sign on Bonus!Various territories available including: ORANGE COUNTY as well as other positions in Staten Island, Queens, Manhattan, Brooklyn, Bronx, Westchester, Rockland, Duchess, Putnam, and Ulster counties.Health Plan rewards full time Assessment Nurses with a higher reimbursement rate when conducting extra visitsField based jobMedical Benefits effective on the first of the month after your start date. The position entails the completion of initial enrollment assessments and reassessments with focus on clinical, psychological, and social needs of the prospects as well as existing members utilizing Uniform Assessment System for (UAS-NY) in accordance with DOH approved policies based on New York State regulations.Assessment Nurse, as part of the interdisciplinary care team is also responsible for completion of DOH approved forms during the face to face visit, which will be incorporated into the Individualized Person Centered Service Plan.Conducts a Uniform Assessment System – New York (UAS – NY) or State approved equivalent for current members and potential members, appropriately enrolling (or not taking under care,) in the member's home or Nursing Home within DOH regulatory timeframes and unit protocols with an error rate of less than 5%.

• Explains program, rules and benefits of the plan in an easy-to-understand language
• Reviews Member handbook, describes provider benefits and responsibilities, coordination of all covered

services and Medicare benefits as applicable

• Conducts functional, psychosocial and environmental safety assessments
• Determines eligibility of enrollees
• Establishes safe plan of care
• Communicates plan of care to member, family, caregivers, healthcare professionals
• All documentation properly signed, correct materials left at home
• Communicates assessment outcome to referral source and assigned business enrollment representative
• Appropriately seeks guidance from assigned Supervisor and Manager, as needed
• All assessments are completed within mandated timeframes as indicated in the departmental

workflows/policies.

• Assessment Nurse is expected to complete at a minimum of 2 (two) assessments per day
• Completes a DOH approved Physician Notification Form and uses as a form of notification in regards to

overall summary for member's health status

• Completes all necessary documentation for CDPAS, when prospect/member verbalizes interest for

enrollment into the program and Initiates completion of Physician Order for CDPAS.Communicates all urgent requests for service, safety issues, changes in condition, or clinical careneeds to PCP and Care Management team upon completion of assessment on same day of identification.

• All urgent issues are communicated verbally and via email to the appropriate Care Manager and Care

Management Supervisor as dictated in departmental workflows

• Obtains orders from the PCP as needed (including skilled home care) and communicates information to the assigned Care Manager and Care Management Supervisor

Creates an individualized Paraprofessional Plan of Care for each prospect/member with an errorrate of less than 5%.

• Paraprofessional Plan of Care is created during the assessment with prospect/ member and/or representative

based on the assessment of the prospect/ member during the evaluation process

• Upon completion of the UAS-NY, Assessment Nurse will communicate appropriately to the assigned Care Manager and Care Management Supervisor in regards to any changes identified, as well as

recommendations

• Assessment Nurse will notify PCP of any changes to the member's Paraprofessional Plan of Care

Submits all assessment related clinical documentation to ENPaperwork or NAPaperwork mailboxwithin established timeframes.

• All documents are submitted within 3 business days, with an error rate of less than 5%
• All submitted documents will have an error rate of less than 5% based on audited sample for completion and accuracy

Completes Request for Service/Appropriateness of Hours visits as per unit protocols withinmandated time frames.

• Conducts a comprehensive UAS-NY assessment to determine member's current needs
• Submits recommendation and supporting documentation to the Care Management team within 1 business

day of completed assessment, in compliance with regulatory and unit timeframes

• Inter-rater reliability reviews will have less than 5% error rate on Request for Service/Appropriateness of Hours recommendations

Qualifications

• Associates Degree in Nursing from an accredited school required, Baccalaureate
• Degree strongly preferred
• A minimum of one year's experience in Community Health, Managed Care, or related field
• Microsoft Word, Excel
• UAS-NY certified