Clinical Enrollment Specialist

4 days ago

Boston MA USA, United States Element Care Full time
Job Summary

Element Care is seeking a highly skilled Clinical Enrollment Specialist to join our team. As a key member of our enrollment team, you will play a vital role in prioritizing, organizing, and adapting the PACE enrollment process to meet the individualized needs of potential participants and ensure census goals are achieved.

Key Responsibilities
  • Enrollment Team Responsibilities:
    • Conduct initial appointments to describe the PACE model to potential participants and their caregivers.
    • Ensure potential participants meet eligibility criteria in accordance with PACE enrollment regulations.
    • Use a strength-based approach to evaluate current needs and health status of potential participants.
    • Proactively communicate with the IDT regarding current enrollment status and progress of prospective participants.
    • Mediate and prioritize between prospective participants/caregivers needs and the IDTs concerns.
    • Participate in weekly Enrollment Team meetings to provide clinical insights, advice, and additional support regarding challenging referrals and other barriers, and conflicts that may arise.
    • Comply and maintain accurate data on new referrals in the CRM, EMR software, and Masshealth Virtual Gateway.
    • Coordinate and assist Marketing and Outreach with outside events.
  • Nurse Coordinator Responsibilities:
    • Visit prospective participants in their home settings to complete and subsequently submit the state-required Minimum Data Set- Home Care (MDS_HC).
    • Complete comprehensive needs/medical assessment intake, including an evaluation of current functional status, caregiver status, current services, and home safety.
    • Present and discuss initial needs assessment intake with the PACE IDT.
    • Determine need for and facilitate additional assessments of prospective participants.
    • Collaborate with IDT to assess prospective participants ability to remain living safely in the community with PACE services.
    • Communicate enrollment status and progress with prospective participant and other significant parties involved in prospective participants care; caregivers, referral sources, homecare providers, case managers, etc.
    • Bridge communication between pertinent parties involved in prospective participants care and PACE IDT to facilitate continuity of care/smooth enrollment transitions.
    • Frequent local travel.
    • Perform other duties as required.
Requirements
  • Associates or Bachelors degree in Nursing, or completion of a Nursing Diploma Program.
  • Licensed as a Registered Nurse in the Commonwealth of Massachusetts.
  • Minimum one (1) year experience in a geriatric healthcare and/or adult mental health setting.
  • Advanced computer skills, including Microsoft Office, Customer Relationship Management, and Electronic Medical Records software.
  • Ability to communicate effectively with and establish working relationships with various medical licensed personnel.
  • Ability to appropriately respond to complex clinical situations in a variety of settings.
  • Strong knowledge of medical/psychiatric diagnosis and treatments.
  • Experience working competently and comfortably with individuals from diverse socio-cultural backgrounds.
  • Ability to assess multiple perspectives and priorities and successfully facilitate within a goal-oriented/solution-focused framework.
  • Skilled customer relations.

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