Company: MetroPlus Health Plan
Location: Jersey City
Posted on: January 12, 2022
About NYC Health + HospitalsMetroPlus Health Plan provides the
highest quality healthcare services to residents of Bronx,
Brooklyn, Manhattan, Queens and Staten Island through a
comprehensive list of products, including, but not limited to, New
York State Medicaid Managed Care, Medicare, Child Health Plus,
Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc.
As a wholly-owned subsidiary of NYC Health + Hospitals, the largest
public health system in the United States, MetroPlus' network
includes over 27,000 primary care providers, specialists and
participating clinics. For more than 30 years, MetroPlus has been
committed to building strong relationships with its members and
providers to enable New Yorkers to live their healthiest
life.Position Overview:The Assessment Nurse is the first person
that the potential member/member and family meet from the MLTC &
FIDA programs. The Assessment Nurse conducts the UAS assessment to
determine the level of care needed to support applicants/members in
the own homes. The Assessment Nurse completes the UAS assessment
tool and makes the determination if an applicant is appropriate for
the MetroPlus MLTC program. The Assessment Nurse also completes the
UAS assessment tool on members already enrolled in the MLTC & PCS
programs upon program enrollment, semi-annually and when there is a
significant change in condition.Job Description
- Meets with applicant, family and caregiver to determine if MLTC
program applicants meet the clinical qualifications for enrollment.
(i.e.; UAS score 5 or greater, needing 120 days of care, safe
- Meet with member, family and caregiver to conduct the UAS tool
for MLTC & PCS program enrollees.
- Conducts a minimum of 15 UAS assessments on a weekly basis
which may include initials, significant change in condition, return
assessments and/or semi-annual/re-assessments.
- Conducts "pop-up/drive-by" visits for members/applicants who
are unable to reach via phone or family member; these visits are
scheduled around the expected minimum UAS assessment per week and
will not change the completion rate expectations.
- Scores the Attendant Care worker tasking tool and shares
potential hours and daycare services with applicant and family
- Discusses other options for applicants that do not meet the
clinical qualifications for the MLTCP.
- Reviews handbook and enrollment documents with applicants who
meet the criteria for enrollment in the MLTCP. Responds to
questions and obtains signature on all necessary documents.
- Reviews findings of assessments and interviews with applicant
and family with Care Manager.
- Conducts reassessments of member pursuant to schedule and in
cases when Care Manager request re-assessment due to change in
condition of the member.
- Participates in MetroPlus quality management activities related
to MLTC & PCS as needed.
- Provides information to the MLTC and PCS management teams
- Performs other tasks assigned by the MLTC & PCS management
- Bachelor's Degree (BSN) required
- A minimum of two (2) to three (3) years clinical experience in
Certified Home Health Agency (CHHA), Lombardi program and MLTC
- Registered Nurse, Currently New York State license
- UAS Certified RN requiredProfessional Competencies
- Integrity and Trust
- Functional/Technical skills
- Written/Oral Communications
- Basic working knowledge of computer systems.
- Excellent communications, written and analytical skills.
Keywords: MetroPlus Health Plan, Jersey City , Assessment Nurse, Healthcare , Jersey City, New Jersey
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