Job Details
A health services network in New York City is currently seeking a licensed Registered Nurse (RN) to join their team in the Queens as a Community Health Nurse. In this role, the Community Health Nurse (RN) will be responsible for directly guiding a prospective participant through the clinical onboarding process leading to enrollment within the network.
Responsibilities:
The Community Health Nurse (RN) will:
- Educate prospective participants on plan benefits, services, and care delivery model
- Assist with administrative functions of the program, including but not limited to, following up on referrals and appointments, as well as tracking and reporting of daily activities
- Work closely with the intake operational team regarding in-home or virtual assessment appointments with prospective participants
- Conduct the pre-enrollment UAS and determines the eligibility of the prospective participant
- Work with the Quality Review team to ensure the accuracy and completeness of all necessary documentation
- Develop the Service plan and obtain enrollment agreement documentation during a home visit or other setting agreed upon with the prospect
- Advise on operational process improvements that may positively impact enrollment turnaround, scheduling logistics, expense/financial-related efficiencies, engagement strategies, reporting, and other critical touchpoints
- Document all interactions and outcomes in the designated clinical management / electronic record system
- Regularly review key performance metrics and analytics to improve process flows and/or quality of work
- Support new staff with onboarding to ensure supportive, collaborative, and efficient transition of new staff to the Clinical Intake Team
- Perform other tasks, as required
Qualifications:
- Prior experience in MLTC, LTTHCP, and/or Managed Care program
- Graduate of an accredited School of Nursing
- NYS Registered Nurse (RN) license
- Solid assessment, clinical, and documentation skills
- Patient oriented
- Great interpersonal skills
- Excellent communication skills (written and verbal)
- Strong attention to detail
- Highly organized
Desired Skills:
- Bilingual
- Experience working with the Geriatric population