Field Registered Nurse

1 month ago

Jamaica, United States tapwage Full time

Essential Duties and Responsibilities:

- Responsible for reviewing favorable and partially favorable determinations in accordance with applicable regulations.
- Render medical necessity determinations for cases assigned.
- Resolve all other technical issues within reconsideration assigned.
- Review cases or sites assigned to determine and summarize facts and assess any issues identified.
- Perform other special projects not related to a specific case such as general legal research, general medical research, drafting proposal sections, or acting as a liaison for a specific project, when necessary.
- Perform other duties as assigned by management.

Primary Responsibilities:

- Develop Home and Community Based Services (HCBS) Plan of Care (POC) in collaboration with child and family that includes evaluation of health status.
- Perform initial in-home evaluations of children that includes evaluation of health status, strengths, care needs, and preferences and guide the development of individualized long-term care service plans.
- Review child’s medical documentation and or health referral forms, as relevant to the case
- Utilize the State CANS assessment tool and MAXIMUS case management systems to document the child’s health status, strengths, care needs, diagnoses and preferences and transmit, as required.
- Properly document any concerns, conflicting information, other issues that surface during the evaluation process
- Emphasize continuity of care, thus reducing or eliminating fragmentation, duplication, and gaps in treatment plan
- Discuss with child/family health care options, supports needed, service vendor options and waiver options.
- Update plans of care as per State requirements, and on an as needed basis
- Collaborate with Family Support Coordinators to meet the needs of the family.
- Enhance communication and collaborative relationships with interdisciplinary care team members to improve care coordination and facilitate service delivery.
- Collect quality review data and any required documentation to support outcome measurements and record case notes into CRM.
- Provide relevant information in response to the child’s specific needs as a bridge between when the in-home evaluation is conducted and evaluation results are provided
- Maintain a comprehensive working knowledge of community resources and network services for target population.
- Meets all standards established for this position as outlined in the corresponding annual performance criteria and bonus template for this position.
- Performs other duties as may be assigned by the Regional Manager or other project management

Minimum Requirements:

- Graduate of an accredited nursing program
- Active RN Licensure in the state of New York
- 2+years relevant experience as an RN
- Active and valid New York driver’s license
- Required ability to travel throughout assigned region, based on business needs.
- Must have reliable form of transportation.
- Ability to review health status questions and make evaluations and determinations based on the UAS-CANS-NY system criteria for enrollment; ability to work with technology in the workplace.
- Knowledge of the theory, principles, and practices of general professional nursing
- Knowledge of state and agency laws and regulations governing general professional nursing practices
- Excellent organizational, interpersonal, written, and verbal communication skills
- Ability to communicate and work effectively with multi-generational consumers.
- Ability to demonstrate sensitivity to the concerns of others.
- Ability to perform comfortably in a fast-paced, deadline-oriented work environment.
- Ability to successfully execute many complex tasks simultaneously.
- Strong ability to work independently.

Minimum Requirements

Minimum Requirements:

- Active RN license required.

Minimum 2 years clinical experience required with RN license.

Preferred Requirements:

- Bachelor’s Degree in Nursing and/or equivalent certification
- Home care experience using the UAS-CANS-NY system
- RN experience in a psychiatric/behavioral health/pediatrics/adolescent/foster care settings/group home/school nurse/care management.
- Consistent technological experience using computer systems for assessments/word processing tasks.
- Experience in developing Plans of Care.

#NYMC #NYMCRegisteredNurse

EEO Statement

Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce. We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a difference for our country. We’re proud of our connections to organizations dedicated to serving veterans and their families. If you are transitioning from military to civilian life, have prior service, are a retired veteran or a member of the National Guard or Reserves, or a spouse of an active military service member, we have challenging and rewarding career opportunities available for you. A committed and diverse workforce is our most important resource. Maximus is an Affirmative Action/Equal Opportunity Employer. Maximus provides equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disabled status.

Pay Transparency

Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Annual salary is just one component of Maximus's total compensation package. Other rewards may include short- and long-term incentives as well as program-specific awards. Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances.

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