Pre-Enrollment RN

4 days ago

Oakland CA United States Center for Elders' Independence Full time

Pre Enrollment RN

The Position:

The Pre-Enrollment RN is responsible for assuring any person requesting enrollment into the PACE program can be cared for appropriately in a community setting and that they meet all requirements for PACE eligibility. The Pre-Enrollment RN performs assessments in person, reviews the assessments of other pre-enrollment Interdisciplinary Team (IDT) members to complete the DHCS Initial Level of Care (ILOC) documentation which summarizes the data gained during pre-enrollment eligibility assessment. This involves a review of all data collected to complete the assessment of the individuals care support network, home environment, and their health condition to determine whether or not their health or safety would be jeopardized by living in a community setting. The Pre-Enrollment RN uses expert clinical skills, critical thinking and judgement, and is responsible for the evaluation of data collected by other clinicians, medical records and/or Interdisciplinary Team (IDT) members to determine if a person meets the minimum requirements for skilled and intermediate nursing needs. Documentation of this assessment and evaluation is the responsibility of Pre-Enrollment RN and may be required to respond to DHCS (state agency) for validation of skilled nursing needs, frailty, complex care needs and comorbidities as needed. The Pre-Enrollment RN must demonstrate clinical competency for the care of frail seniors. Nursing job duties are to meet the Nurse Practice Act, CMS PACE Regulations 42 CFR 460. 180, Center for Elders Independence Code of Conduct, and professional education standards.

The hourly range for the Pre Enrollment RN position at Center For Elders Independence is $ 43.81 - $ 65.71 per hour. Hourly based on the market for the Pre Enrollment RN position, as well as experience, skills, abilities and work history.

General Duties and Responsibilities:

  • Conduct nursing assessments and examination to assess for eligibility while using motivational interviewing techniques, use of evidence-based tools, such as the frailty index for elders (FIFE) and identify participants who may meet the high risk health and safety denial guidelines for the PACE program.
  • Perform physical examination, chart review and integrate other interdisciplinary team members assessments in evaluating eligibility criteria and minimum level of care (skilled nursing) for enrollment into the PACE program.
  • Perform any necessary screening, interventions, diagnostic testing, or medication review to assure comprehensive evaluation of minimum eligibility requirements necessary for enrollment.
  • Initiate huddles with the center anchor physician/provider team and other/or key disciplines to discuss individuals who may meet the criteria for denial based upon on the high risk, health and safety guidelines and ensure additional assessments are conducted timely.
  • Determine if sufficient data supports that the prospective PACE enrollees health or safety would be jeopardized by remaining in a community setting or enrollment into the PACE program using the Health & Safety High Risk criteria, the Pre-Enrollment RN works collaboratively with the PACE Intake Specialist to request denial of enrollment.
  • Collaborate and participate with PACE Intake Specialist to present assessment and ILOC data to the center Interdisciplinary Team (IDT).
  • Completes assigned nursing training and competency validation requirements on time. Performs other duties as assigned.
  • Perform all other related duties as assigned.

Qualifications:

  • BSN Degree in Nursing, preferred.
  • Minimum of two to five years experience in community based/healthcare hospital or tertiary care, required.
  • 1 year minimum experience with the elderly population.
  • Bilingual: Spanish/English or English/Cantonese/Mandarin, preferred.
  • Demonstrates clinical competency and technical skills for the elderly patient population.
  • Demonstrates knowledge of regulatory requirements in delegation of tasks to clinical support staff.
  • Ability to prioritize Provider requests i.e. testing or other procedures related to patients visit and/or required follow up care.
  • Excellent verbal and written communications including demonstrated strong interpersonal and presentation skills.
  • Strong organizational and analytical/problem-solving skills in participant care environments.
  • Demonstrates ability to function independently, evaluate and guide other Interdisciplinary Team (IDT) members to collect appropriate information or data that help facilitate the completion of assessments, determine skilled or intermediate nursing needs for submission for enrollment into PACE.
  • Demonstrates knowledge and apply all regulatory requirements in completing nursing assessments, delegation of tasks and proper documentation.

Additional Job Requirements

  • Ability to sit, stand, stoop, reach, lift (up to 10 pounds), bend, etc., hand and wrist dexterity to utilize computer.
  • May require travel to sites/program and special functions.
  • Environmental Conditions Critical to Performance:
    • Work is in an office environment, climate controlled through central air conditioning.
    • May have some exposure to outside environments while traveling.
    • May be required to perform work duties in the community, patient homes or PACE Centers.

The above job description is intended to communicate the general function of the mentioned position and by no means shall be considered an exhaustive or complete outline of the specific tasks and functions that will be required.CEI reserves the right to change job descriptions, site assignments, and or work hours as required by the needs of the program.All employees are expected to perform their duties within their ability as required by the job and/or as requested by management.

Center for Elders Independence is a PACE (Program of All- Inclusive Care for the Elderly) organization that uses an interdisciplinary team approach to care planning and care implementation for the purpose of providing high quality, affordable, integrated health care services to the elderly, including an Adult Day Health Center, and promoting autonomy, quality of life and the ability of individuals to live in their communities. Unlike other healthcare plans, CEI is not a "fee-for-service" plan. It is a capitation healthcare plan. CEI is paid a set amount for each person enrolled in our program, whether or not that individual seeks care. We are a growing company that offers stability and continues to thrive.

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