UAS / Intake Nurse
at RCM Health Care Services

Date Posted: 4/8/2019

Job Description

Leading MLTC program is looking for a number of Intake specialist/UAS Rn's to join their growing team.

Enrollment Specialist / UAS RN - Looking for candidates to cover Suffolk/Nassau as wells Queens/Brooklyn.

Job Summary: Responsible for enrollment of new members by collaborating with caregivers and PCP.

Responsibilities:
  • Provides assessment of newly referred patients, assess health needs and eligibility for home care services.
  • Develops and implement treatment plans in conjunction with the Home Care Coordinator, Physician, and patient/caregiver.
  • Conferences with Care Manager and Enrollment Manager to assure appropriate services are in place.
  • Documents accurately and completely in patients clinical record.
  • Submits written documentation on timely basis in accordance with Agency policy.
  • Makes referral for other services as needed.
  • Maintains updated professional knowledge and participates in patient education programs to ensure optimum quality of patient care.
  • Perform other nursing activities as directed.
  • Conducts comprehensive clinical, psycho-social, and financial risk assessments of potential members for enrollment to the MLTC program across multiple regions.
  • Evaluates appropriateness of membership based on NYS assessment criteria.
  • Develops initial plan of care for new members, which includes selecting and authorizing services, supplies, equipment, environmental modification, durable medical equipment and medications, etc. Collaborates with Nurse Care Manager on implementation of the plan of care.
  • Identifies appropriate home health aide hours based on Personal Care Assessment/other appropriate tools and program guidelines; with member and family regarding level of service.
  • Obtain complete and accurate information for each potential enrollee. Approves eligibility of potential enrollee based on government standards and program criteria such as Universal Assessment Tool II, medical coverage, age, etc. Reviews application for completion and accuracy.
  • Stays abreast of current and potential changes to federal, state and local statutes and regulations and applicable quality assurance standards. Makes recommendations to of Enrollment Manager based on changes.
  • Makes recommendations in regard to enrollment policies and procedures. Adheres to MLTC rules and regulations.
  • Participates in special projects and performs other duties, as required.

Qualifications and Experience:
  • Current New York State License as Registered Nurse
  • One (1) year general Medical Surgical Nursing experience required
  • UAS certification Required
  • Able to meet health standards of employment
  • Must successfully complete orientation
  • Prior home care experience preferred

Job Snapshot

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