- Responsible for reviewing favorable and partially favorable determinations in accordance with applicable regulations.
- Render medical necessity determinations for cases assigned.
- Resolve all other technical issues within reconsideration assigned.
- Review cases or sites assigned to determine and summarize facts and assess any issues identified.
- Perform other special projects not related to a specific case such as general legal research, general medical research, drafting proposal sections, or acting as a liaison for a specific project, when necessary.
- Perform other duties as assigned by management.
Primary Responsibilities: - Develop Home and Community Based Services (HCBS) Plan of Care (POC) in collaboration with child and family that includes evaluation of health status.
- Perform initial in-home evaluations of children that includes evaluation of health status, strengths, care needs, and preferences and guide the development of individualized long-term care service plans.
- Review child's medical documentation and or health referral forms, as relevant to the case
- Utilize the State CANS assessment tool and MAXIMUS case management systems to document the child's health status, strengths, care needs, diagnoses and preferences and transmit, as required.
- Properly document any concerns, conflicting information, other issues that surface during the evaluation process
- Emphasize continuity of care, thus reducing or eliminating fragmentation, duplication, and gaps in treatment plan
- Discuss with child/family health care options, supports needed, service vendor options and waiver options.
- Update plans of care as per State requirements, and on an as needed basis
- Collaborate with Family Support Coordinators to meet the needs of the family.
- Enhance communication and collaborative relationships with interdisciplinary care team members to improve care coordination and facilitate service delivery.
- Collect quality review data and any required documentation to support outcome measurements and record case notes into CRM.
- Provide relevant information in response to the child's specific needs as a bridge between when the in-home evaluation is conducted and evaluation results are provided
- Maintain a comprehensive working knowledge of community resources and network services for target population.
- Meets all standards established for this position as outlined in the corresponding annual performance criteria and bonus template for this position.
- Performs other duties as may be assigned by the Regional Manager or other project management
Minimum Requirements: - Graduate of an accredited nursing program
- Active RN Licensure in the state of New York
- 2+years relevant experience as an RN
- Active and valid New York driver's license
- Required ability to travel throughout assigned region, based on business needs.
- Must have reliable form of transportation.
- Ability to review health status questions and make evaluations and determinations based on the UAS-CANS-NY system criteria for enrollment; ability to work with technology in the workplace.
- Knowledge of the theory, principles, and practices of general professional nursing
- Knowledge of state and agency laws and regulations governing general professional nursing practices
- Excellent organizational, interpersonal, written, and verbal communication skills
- Ability to communicate and work effectively with multi-generational consumers.
- Ability to demonstrate sensitivity to the concerns of others.
- Ability to perform comfortably in a fast-paced, deadline-oriented work environment.
- Ability to successfully execute many complex tasks simultaneously.
- Strong ability to work independently.
Minimum Requirements: - Active RN license required.
- Minimum 2 years clinical experience required with RN license.
Preferred Requirements: - Bachelor's Degree in Nursing and/or equivalent certification
- Home care experience using the UAS-CANS-NY system
- RN experience in a psychiatric/behavioral health/pediatrics/adolescent/foster care settings/group home/school nurse/care management.
- Consistent technological experience using computer systems for assessments/word processing tasks.
- Experience in developing Plans of Care.
EEO Statement
Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce. We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a difference for our country. We're proud of our connections to organizations dedicated to serving veterans and their families. If you are transitioning from military to civilian life, have prior service, are a retired veteran or a member of the National Guard or Reserves, or a spouse of an active military service member, we have challenging and rewarding career opportunities available for you. A committed and diverse workforce is our most important resource. Maximus is an Affirmative Action/Equal Opportunity Employer. Maximus provides equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disabled status.
Pay Transparency
Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Annual salary is just one component of Maximus's total compensation package. Other rewards may include short- and long-term incentives as well as program-specific awards. Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances.
Annual Base Pay Minimum for this Position
$95,000.00
Annual Base Pay Maximum for this Position
$100, -
Home Care Scheduler
1 week ago
East Boston Neighborhood Health Center Boston, United States**Thank you for your interest in careers at EBNHC**: · Everywhere you turn, you can feel it. There's an immeasurable level of enthusiasm at East Boston Neighborhood Health Center (EBNHC), one of the largest community health centers in the country. From the nurses and physicians o ...
-
Home Care Aide
1 week ago
Immaculate Home Care Services - Woburn, MA Woburn, United States**Benefits**: · - Flexible schedule · - Training & development · **Benefits/Perks** · - Flexible Scheduling · - Competitive Compensation · - Careers Advancement · We are looking for a Home Care Aide to join our team You will be directly working with patients, following a one-on-o ...
-
Home Care Case Manager
5 days ago
Tribute Home Care Boston, United StatesBecome a** Case Manager** with Tribute Home Care and play an important role in setting a new standard in elder care. · Make a difference - Find meaning - Lead - Collaborate - Grow - Have a voice - Laugh - Love your team · Tribute Home Care is looking for a customer-service focuse ...
-
Team Leader, State Home Care Programs
1 day ago
Somerville Cambridge Elder Services Somerville, United States**Job Title: Team Leader, State Home Care Programs** · **Reports To: Manager, State Home Care Programs** · **Department: Home and Community-Based Services** · **FLSA Status: ☐Exempt or ☒Non Exempt** · **☒Union or ☐ Non-Union** · ***: · The State Home Care Programs Team Leader is ...
-
Home Care Liaison/sales
5 days ago
Home Helpers of Metro West Wayland, United States**Benefits**: · - 401(k) · - 401(k) matching · - Bonus based on performance · - Competitive salary · - Dental insurance · - Flexible schedule · - Health insurance · - Paid time off · - Vision insurance · Established in 2012, Home Helpers of MetroWest is a well-known and respected ...
-
Home Care Program Care Manager
3 days ago
Old Colony Elder Services Brockton, United States**OCES** aims to support elders and individuals with disabilities by providing vital information and coordination of services that promote healthy, safe lives for our consumers. We want to help them stay as active and engaged in their lives and in their own communities for as lon ...
-
Supervisor for Home Care
3 days ago
Springwell Waltham, United StatesJob Description · Job DescriptionSpringwell is expanding our leadership team Join us as a supervisor and learn valuable skills to enhance your career. · POSITION DESCRIPTION: · Springwell is seeking a supervisor for the Home Care program at our Waltham office. This Supervisor pro ...
-
Home Care Aide Lynn
1 week ago
A Season Home Care LLC Lynn, United States**Benefits/Perks** · - Flexible Scheduling · - Competitive Compensation · - Careers Advancement · **Job Summary** · We are looking for a **Home Care Aide** to join our team You will be directly working with patients, following a one-on-one care plan in patient homes. You operate ...
-
Business Development Home Care
1 week ago
FCP Live-In Braintree, United States**About FCP Live-In Home Care**: · **For 26 years we have provided Live-In Elder Care Services. We are FCP Live-In a large and fast growing Live-in Elder Care Agency specializing in Post-Acute Care and Transitional Care to Reduce Hospital Readmissions and to keep Mom and Dad at H ...
-
Children's Home Care Provider
1 week ago
LifeConnections Nashua, United States**LifeConnections Children's Foster Care Providers in the Manchester area** · **Compensation**: $25K/Year, Tax Free, Per Child. · **Position**:Foster Care Provider · **Location**:Nashua, NH region. · **Description**: · LifeConnections Children's Foster Care services is currently ...
-
Home Care Office Manager
23 hours ago
Paramount Healthcare Services Inc. Chelmsford, United StatesParamount Healthcare Services is seeking an Office Manager who is compassionate, kind and with excellent customer service skills, who is willing to go above and beyond their duties. Your duties would include submitting and following up on prior authorizations, managing payers inc ...
-
RN-Home Health Care
4 days ago
Element Care Brighton, MA, United StatesGENERAL SUMMARY · Functions as an integral part of an enrollment team to prioritize, organize, and adapt the PACE enrollment process to meet potential participants' individualized needs and to ensure census goals are achieved. Works as a clinical liaison between prospective part ...
-
Elite Medical at Home Quincy, United States**Job description** · **RESPONSIBILITIES** · - Manage intake of new referrals/ enter new patients into home care EMR system · - Oversee clinical staff schedules and place them on home care assignments · - Provide office support to field clinical staff, providing them with all req ...
-
VNA Care Southborough, United States OTHER**At Home Private Care** is seeking a dynamic** Director** to oversee the day-to-day operations, coordination of services, and oversight of referrals to achieve sales goals. · Office location: 333 Turnpike Road (Rt 9) Southborough, MA 01772 · Responsibilities include: · Managemen ...
-
Home Health Aide Home Care Boston
4 days ago
HCAOA Somerville, United StatesWe change the world everyday and want to meet you · Right at Home, In-Home Care & Assistance, is seeking to hire CNA's and Home Health Aides to join a dynamic care team providing clinical expertise in-home. We have immediate part-time and full-time positions available. You can m ...
-
Home Health Aide Home Care Cambridge
4 days ago
HCAOA Somerville, United StatesWe change the world everyday and want to meet you · Right at Home, In-Home Care & Assistance, is seeking to hire CNA's and Home Health Aides to join a dynamic care team providing clinical expertise in-home. We have immediate part-time and full-time positions available. You can m ...
-
Home Health Aide Home Care Cambridge
5 days ago
HCAOA Somerville, United StatesWe change the world everyday and want to meet you · Right at Home, In-Home Care & Assistance, is seeking to hire CNA's and Home Health Aides to join a dynamic care team providing clinical expertise in-home. We have immediate part-time and full-time positions available. You can m ...
-
Therapist, Respiratory Home Care
2 weeks ago
Aureus Medical Group Cambridge, MA, United StatesPhysical Therapist traveler needed primarily for home care environment with support from a large interdisciplinary team (IDT) within the PACE model of care.40 hours per weekM-F, 8AM-4:30PMPACE is a Program for the All Inclusive Care for the Elderly, utilizing dual benefits to pro ...
-
Home Health Rn Patient Care Manager
1 week ago
LHC Group Westborough, United States**We are hiring for a Full time Patient Care Manager RN with Home Health experience to help us with our growing clients** · Pay Ranges Starting at: $104K+ · At **Caretenders**, a part of LHC Group, we embrace a culture of caring, belonging, and trust and enjoy the meaningful conn ...
-
Spanish Speaking Lpn Home Health Care
23 hours ago
Essex Home Health Andover, United StatesJob Summary: · **Duties**: · - Conduct patient assessments and develop individualized care plans · - Administer medications and treatments as prescribed · - Monitor patient conditions and report changes to healthcare providers · - Educate patients and families on managing illness ...
Field Registered Nurse Home Care - Watertown, United States - Maximus
Description
Description & Requirements
Maximus is currently hiring for a Field Registered Nurse - Home Care to support our C-YES Program. (Children and Youth Evaluation Services).
This is a full time, hybrid-remote position that will require travel throughout territories of Buffalo, Cattaraugus, Rochester, Niagra Falls, and Canandaigua, New York.
Maximus has partnered with the New York State Department of Health to establish the Children and Youth Evaluation Service (CYES) program to determine whether a child or youth is eligible for home and community-based services (HCBS) covered by Medicaid. The Field Nurse Evaluator will be working in the community conducting strength-based assessments for families who have children (ages 0-21) with behavioral health/psychiatric issues. All nurses are provided support and education for ongoing professional development and annual certification in the CANS-NY assessment tool. The assessments will be the basis for family-driven Plan of Care (POC) development to support the family's access to Home and Community Based Services (HCBS). The Nurse Evaluator will conduct 1-2 assessments a day and work with a Family Support Coordinator to meet the family's case management needs specifically related to the HCBS POC.
Essential Duties and Responsibilities:
