Brooklyn NY 11201
Job DescriptionTERRITORIES INCLUDE: Bronx, Manhattan and Westchester
LANGUAGES: Spanish and Chinese highly preferred, but all bilingual candidates considered
This is a physical position which includes lifting/carrying a minimum of 25 lbs of equipment/materials, climbing stairs to the subway or to a member’s apartment, etc.
Responsible for the completion of UAS (Uniform Assessment System) Initial Assessments and Reassessments based on New York state requirements, guidelines and training provided by the company and/or outside resources; enrollment paperwork materials required to appropriately process member`s application for enrollment; and UAS Tasking Tool based on guidelines and training provided by the company and/or outside resources. Responsible for correction and revision of UAS, paperwork, and tasking tool documentation based on review and feedback provided through quality and associated review processes.
- Completes approved New York State UAS Initial Assessment Tool and/or Clinical Reassessment used to define eligibility for community based long term care services; develops plan of care for members.
- Completes enrollment paperwork, progress notes and tasking tool in member`s home to assist in determining eligiblity for services; reviews all data collected for accuracy and completion prior to submission.
- Charts all contacts and findings within appropriate tool and form per policy and procedure and within deadlines.
- Attends training and continuing education sessions focused on the proper completion of UAS documentation, enrollment paperwork, and tasking tool.
- Focuses on continuous improvement and quality excellence in the completion of all material associated with the initial enrollment/continued enrollment of members in the plan.
- Supports initiatives of the Quality Assessment and Performance Improvement Committee
- This is a physical position which includes lifting/carrying a minimum of 25 lbs of equipment/materials, climbing stairs to the subway or to a member’s apartment, etc.
General Job Information
Job FamilyClinical Services Group
CountryUnited States of America
FLSA StatusUnited States of America (Exempt)
Recruiting Start Date9/12/2018
Date Requisition Created9/12/2018
EducationAssociates: Nursing (Required), Bachelors: Nursing
License and Certifications - RequiredRN - Registered Nurse, State and/or Compact State Licensure - Care Mgmt
License and Certifications - PreferredCCM - Certified Case Manager - Care Mgmt, CCP - Chronic Care Professional - Care Mgmt
Other Job Requirements
- Minimum 2 years clinical experience with focus in managed care, including disease or case management.
- Trained and knowledgeable in the NY UAS. Ability to understand and apply principals of Care Management and Person Centered Service Planning.
- Solid assessment skills.
- Ability 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).
- Understands and adapts appropriately to issues related to communication, cognitive or other barriers.
- Strong organizational skills and the ability to prioritize and follow through on multiple projects in a timely manner.
- Must be comfortable with conducting home visits and commuting within the service area.
Must be able to travel multiple boroughs via car or commuting via public transportation.
- Basic computer skills and demonstrates a willingness to learn more advanced skills.
- Home Care, Long-Term Care, MLTC experience preferred, including appropriate support services in the community and accessing and using durable medical equipment (DME).
- Experience in utilization review, concurrent review and/or risk management a plus.
- Bi or multilingual.
Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled
“I receive a high level of support from our Senior Management Team to execute on our vision. They are always accessible and approachable, something I’ve found to be very unique to Magellan.”