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Registered Nurse- Enrollment PACE
3 months ago
About Us
Community health is about more than just vaccines and checkups. It’s about giving people the resources they need to live their best lives. At Neighborhood, this is our vision. A community where everyone is healthy and happy. We’re with you every step of the way, with the care you need for each of life’s chapters. At Neighborhood, we are Better Together.
Neighborhood Healthcare PACE is a managed medical plan built around surrounding participants with a team of physicians, nurses, social workers, therapists and care coordinators to help them maintain good health and a good quality of life. Our goal is to keep our seniors happy and healthy at home surrounded by their family and community.
As a private, non-profit 501(C) (3) community health organization, we serve over 500k medical, dental, and behavioral health visits from more than 90k people annually. With two PACE centers located in Riverside County, our PACE program is positioned to serve over 650 senior participants.
ROLE OVERVIEW and PURPOSE
The Registered Nurse (RN) Enrollment works to support the mission and vision of Neighborhood Healthcare (NHC) by providing outreach and enrollment services to patients for Neighborhood Healthcare’s Program for All-Inclusive Care for the Elderly (PACE). This role will follow leads for prospective PACE enrollees to complete assessments to determine eligibility into the program. In addition, this role will play a critical part in initiating the coordination of care for newly enrolled patients.
RESPONSIBILITIES
- Responds to individual inquiries regarding PACE, including phone calls, web site inquiries, walk-ins, home visits, hospital, and nursing home visits
- Provides tours of PACE centers to interested family members, potential participants, community partners, and providers
- Reviews the enrollment process with potential enrollees, families, and referring parties
- Provides detailed medical history and lifestyle assessments to applicants enrolling in PACE in-home and the PACE center
- Provides referrals to other programs for individuals not appropriate for PACE and for those who choose not to enroll
- Serves as the liaison for California Department of Health Care Services (DHCS) level of care (LOC) assessments
- Assesses and documents patient statuses to support the regulatory reviews and approvals of initial enrollments (LOC for PACE)
- Organizes and submits reporting information to DHCS, such first submission, resubmission, or deferral status for applicants or prospective enrollees
- Coordinates with the intake team if additional applicant information is required
- Monitors the statuses of DHCS submissions and coordinates with enrollment team
- Conducts full medical and environmental in-home assessments on prospective enrollees
- Coordinates with home care team when reassessments are required for applicants
- Performs patient assessments to identify and address overt problems/needs; including priority setting, referrals and follow-ups, diagnostics review, medical record interpretation, and data collection to complete required forms for compliance
- Participates on the Interdisciplinary Team (IDT) to provide information for enrollment decisions and ongoing communication with referral sources, potential enrollees, and families during the intake process
- Creates initial care plans with participant during care planning stage with IDT
- Completes appropriate documentation related to participant assessments as required
- Prepares and oversees the semi-annual level of care on-site audits in coordination with other IDT members
- Observes and reports changes in participants physical, mental, emotional, and social functioning to the IDT
- Keeps informed of PACE eligibility requirements, general Medicaid eligibility guidelines, and supplemental insurance issues as they affect enrollment and the Medicare CMS regulation for PACE
- Conducts clinical presentations, as required
- Provides responsive and high-quality services to patients, team members, and outside organizations
- Provides input and feedback on PACE’s internal and external outreach, education, and enrollment plan for engaging, assisting, enrolling, and retaining new and current enrollees
EDUCATION/EXPERIENCE
- Associate's degree in nursing required; bachelor’s degree in nursing preferred
- California Registered Nurse license in good standing
- BLS (Basic Life Support) certification upon hire required
- One year experience working with frail elderly populations is preferred
- Bilingual (English/Spanish) is preferred
- Valid CA Driver’s License and proof of auto insurance is required to travel to complete home assessments.
ADDITIONAL QUALIFICATIONS (Knowledge, Skills, and Abilities)
- Excellent verbal and written communication skills, including superior composition, typing, and proofreading skills
- Ability to interpret a variety of instructions in written, oral, diagram, or schedule form
- Knowledgeable about and experience with working in senior or elder care setting – PACE, Nursing Home, Hospice, ADHC preferred
- Ability to take and pass the State of California DHCS PACE and Medi-Cal Marketing Certification exam within 60 days of hire
- Ability to interact professionally and respectfully with geriatric individuals including those with cognitive decline and/or physical frailties
- Ability to successfully manage multiple tasks simultaneously
- Excellent planning and organizational ability
- Ability to work as part of a team as well as independently
- Ability to work with highly confidential information in a professional and ethical manner
Physical Requirements
- Ability to lift/carry 50 lbs./weight
- Ability to stand for extended periods of time
COMPLIANCE (Safety & HIPPA)
- Follow all safety procedures as outlined in Neighborhood Healthcare’s Illness and Injury Prevention Plan (IIPP) and report any injuries and/or unsafe conditions immediately
- Maintain current knowledge of policies and procedures as they relate to safe work practices
- Follow all safety procedures and report unsafe conditions
- Use appropriate body mechanics to ensure an injury free environment
- Be familiar with location of nearest fire extinguisher and emergency exits
- Follow all infection control procedures including blood-borne pathogen protocols
- Maintain privacy of all patient, employee and volunteer information and access such information only on a need-to-know basis for business purposes
- Comply with all regulations regarding corporate integrity and security obligations
- Report all behavior and/or activity that are unethical, fraudulent, or unlawful
Neighborhood Healthcare offers a generous benefit plan that includes: Partially company paid Medical, Dental, and Vision Plans. Two plus weeks of vacation, Nine Holidays including two Floating Holidays of your choosing, Sick/Personal time, Volunteer Time Off (VTO), 403b Retirement plan (similar to a 401k), optional Health and Wellness events, and much more
Pay range: $52.22 - $60.87 per hour, depending on experience.
