This is a traveling position. The candidates will travel to Brooklyn, Queens, The Bronx, Manhatten, and West Chester. On very few occasions, the candidate may have to travel between two cities on one day, but that is not likely. The position is M-F with the typical hours of 9am - 5pm; however there is some flexibility with the hours.
Responsibilities:
- UAS Initial Assessments and Reassessments based on NY State requirements and guidelines and training provided.
- Enrollment paperwork materials required to appropriately process consumer’s application for enrollment.
- UAS Tasking Tool based on guidelines and training.
- Responsible for correction and revision of UAS, paperwork, and tasking tool documentation based on review and feedback provided through quality and associated review processes.
Essential Functions:
- Complete UAS Initial and/or Reassessment documentation, enrollment paperwork, and tasking tool in the consumer’s home.
- Attend training and continuing education sessions and lessons focused on the proper completion of UAS documentation, enrollment paperwork, and tasking tool.
- Focus on continuous improvement and quality excellence in the completion of all material associated with the initial enrollment/continued enrollment of consumers as members in the plan.
- Supports initiatives of the Quality Assessment and Performance Improvement Committee.
- UAS Assessor experience is a MUST!!!
- Minimum 5 years clinical experience with focus in managed care, including behavioral health disease or case management.
- Care Mgmt.\RN - Registered Nurse, State and/or Compact State Licensure.
- Bilingual in Spanish.
- Understands and is able to apply principals of Care Management and Person Centered Service Planning
- Is able to apply Milliman Care Guidelines and other applicable, evidenced-based clinical guidelines.
- Is able to understand and apply coverage guidelines and benefit limitations.
- Familiar with clinical needs and disease processes for chronic physical and behavioral illnesses (depression, challenging behaviors, Alzheimer’s disease and other disease-related dementias).
All your information will be kept confidential according to EEO guidelines.
