Community Health Professional

2 weeks ago


Ridgewood, United States Tandym Group Full time
Job Summary

Tandym Group is currently seeking a skilled Registered Nurse to fill the role of a Community Health Nurse in Queens, New York. This position involves providing direct care to prospective participants and guiding them through the clinical onboarding process.

Responsibilities:
  1. Education and Guidance: Educate prospective participants on plan benefits, services, and care delivery models
  2. Administrative Support: Assist with administrative functions, including follow-up on referrals and appointments, as well as tracking and reporting of daily activities
  3. Intake Coordination: Work closely with the intake operational team regarding in-home or virtual assessment appointments with prospective participants
  4. Eligibility Determination: Conduct pre-enrollment UAS and determine eligibility of prospective participants
  5. Quality Assurance: Collaborate with the Quality Review team to ensure accuracy and completeness of all necessary documentation
  6. Service Planning: Develop service plans and obtain enrollment agreement documentation during home visits or other agreed-upon settings
  7. Process Improvement: Advise on operational process improvements that positively impact enrollment turnaround, scheduling logistics, expense/financial-related efficiencies, engagement strategies, reporting, and other critical touchpoints
  8. Documentation: Document all interactions and outcomes in designated clinical management/electronic record systems
Requirements:
  • Prior experience in MLTC, LTTHCP, and/or Managed Care programs
  • Graduate of an accredited School of Nursing
  • NYS Registered Nurse (RN) license
  • Solid assessment, clinical, and documentation skills
  • Patient-oriented approach
  • Excellent communication and interpersonal skills
  • Strong attention to detail
  • Highly organized


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