Registered Nurse- Enrollment-PACE
hace 4 días
Murrieta
Job Description 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. As a private, non-profit 501(C) (3) community health organization, we serve over 500,000 medical, dental, and behavioral health visits from more than 100,000 people annually. We do this in pursuit of our mission to improve the health and happiness of the communities we serve by providing quality care to all, regardless of situation or circumstance. Since 1969, our employees have been making this mission a reality. Regardless of the role, our team focuses on being compassionate, having integrity, being professional, always collaborating, and consistently going above and beyond. If this sounds like an organization you would like to be a part of, we would love to meet you. 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. This is a remote-based position that requires frequent fieldwork conducting in-home assessments for PACE applicants. Monthly in-person meetings are also required. 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 Education/Experience • Associate's degree in nursing required, • Bachelor's degree in nursing preferred, • CA RN license required, • Active BLS certification required upon hire, • One year experience working with frail elderly populations is preferred, • Bilingual (English/Spanish) is preferred, • 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 lift/carry 50 lbs./weight Pay range: $45.87 - $67.93 per hour, depending on experience. This role is eligible for a $2,500 signing bonus. Compensation Disclosure: The posted salary range reflects the designated pay grade for this position. While this range represents the broader classification of the role, actual compensation will be based on several factors, including but not limited to the candidate’s overall knowledge, skills, and experience, market data and industry benchmarks, internal equity within the organization, Budgetary considerations and organizational needs. As a result, placement within the range is not guaranteed, and the full pay grade range may not be utilized.