Health Home RN

2 weeks ago


Everett MA United States Eliot Community Human Services Full time

$3,000 Sign-on Bonus

Eliot's behavioral health program is seeking an energetic, empathic, Registered Nurse (RN) to serve as part of an interdisciplinary team in the coordination of medical, behavioral health and Social Determinants of Health (SDOH) needs. The ideal candidate will have a strong commitment to mental health recovery, substance abuse disorders and the coordination of integrated care.

Eliot's One Care Health Home program is an innovative Care Management approach for members with complex medical, behavioral health, and social needs who are dual eligible, having both Masshealth and Medicare benefits.

Responsibilities:

* Responsible for annual (MDS) Comprehensive Assessment and supplement(s)
* Provide insight and guidance regarding Member's Person-Centered Care Plan (PCCP)
* Coordinate authorizations and service referrals with Commonwealth Care Alliance (CCA) Utilization Management and Clinical Operations Team and participate in care transitions and post-discharge follow-up where indicated.
* Provide 24/7 rotating On-call coverage.
* Document care coordination activities and data such as member and provider engagement, assessments, care plans, service referrals, care transitions work, and member demographic information, in CCA's electronic platforms
* Provide education, consultation, and care coordination to active enrollees on the Health Home team.
* Provide interventions and supports to enrollees regarding medical health, medication, and medical topics.
* Provide 1:1 training in specific individualized need areas for assigned enrollees.
* Develop and conduct groups and training for enrollees in general areas of health and wellness including nutrition, exercise, smoking cessation, diabetes, and prevention.
* Assist enrollees with accessing community resources that will support and assist with addressing needs and health wellness efforts.

Qualifications: Must be a licensed registered nurse with at least two years of experience working with people with severe and persistent mental illnesses or at least two years of providing medical coordination. Must have skills to establish supportive relationships with persons with severe and persistent mental illnesses and respect for their preferences for treatment. Must have the ability to work on a team that provides care coordination services and interventions. Computer literacy and skill in the use of computers and related software applications. Ability to consistently meet all necessary background and credentialing requirements. Must have a valid driver's license and reliable transportation. Must have a reliable telephone notification system for emergency/on-call contact.

Schedule: Monday-Friday 9am-5pm

Service Areas: Lowell, Lawrence, Lynn, North Shore, Everett and Malden offices.

Salary: $70k

Eliot is committed to identifying and dismantling barriers that prevent people with marginalized racial identities from actualizing their full employment potential, assuming leadership roles, or from fully engaging at all levels in the workplace.


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