Mltc Community Health Nurse

A healthcare network in New York City is currently seeking a licensed Registered Nurse (RN) to join their team in the Bronx 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