Job Description

Job Summary

Provides support for the completion of the Community Health Assessment (CHA) - formerly the 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. Completes enrollment paperwork materials required to appropriately process member applications for enrollment and CHA tasking tool in alignment with guidelines and training provided by the company and/or outside resources. Facilitates correction and revision of CHA paperwork and tasking tool documentation based on review and feedback provided through quality/review process.

Job Duties

- Completes approved New York State initial assessment tool and/or clinical reassessment used to define eligibility for community-based long-term care services for members.
- Completes enrollment paperwork, progress notes and tasking tool in member homes to assist in determining eligibility 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 established deadlines.
- Attends training and continuing education sessions focused on the proper completion of Comprehensive Health Assessment (CHA) documentation, enrollment paperwork, and tasking tool.
- Focuses on continuous improvement and quality excellence in the completion of all materials associated with the initial enrollment/continued enrollment of members in the plan.
- Supports initiatives of the quality assessment and performance improvement committee.
- 25- 40% estimated local travel may be required (based upon state/contractual requirements).

Job Qualifications

Required Qualification:

- At least two years of clinical experience in managed care - including case management and home visit experience, or equivalent combination of relevant education and experience.
- Registered Nurse (RN). License must be active and unrestricted in state of practice (NY).
- Must reside in the state of New York or neighboring states (NJ, CT, parts of PA). Must have a NY state government ID.
- Trained and knowledgeable in the New York Uniform Assessment System (UAS).
- Must be able to travel to multiple boroughs via car or commuting public transportation.
- Understands and applies principles of care management and person-centered planning.
- Solid assessment skills.
- Understands and applies coverage guidelines and benefit limitations.
- Familiar with clinical needs and disease processes for chronic physical and behavioral illnesses.
- Understands and adapts appropriately to issues related to member communication, cognitive or other barriers.
- Organizational skills, and ability to prioritize and follow through on multiple projects in a timely manner.
- Effective verbal and written communication skills.
- Microsoft Office suite and applicable software programs proficiency.

Preferred Qualification:

- Certified Case Manager (CCM) or Chronic Care Professional (CCP).
- Home care or long-term care experience.
- Community support service experience accessing and using durable medical equipment (DME).
- Experience in utilization review, concurrent review and/or risk management.
- Bilingual or multi-lingual in Chinese (Mandarin or Cantonese), or Spanish.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Provides support for the completion of the Community Health Assessment (CHA) - formerly the 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. Completes enrollment paperwork materials required to appropriately process member applications for enrollment and CHA tasking tool in alignment with guidelines and training provided by the company and/or outside resources. Facilitates correction and revision of CHA paperwork and tasking tool documentation based on review and feedback provided through quality/review process. Job Duties - Completes approved New York State initial assessment tool and/or clinical reassessment used to define eligibility for community-based long-term care services for members. - Completes enrollment paperwork, progress notes and tasking tool in member homes to assist in determining eligibility 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 established deadlines. - Attends training and continuing education sessions focused on the proper completion of Comprehensive Health Assessment (CHA) documentation, enrollment paperwork, and tasking tool. - Focuses on continuous improvement and quality excellence in the completion of all materials associated with the initial enrollment/continued enrollment of members in the plan. - Supports initiatives of the quality assessment and performance improvement committee. - 25- 40% estimated local travel may be required (based upon state/contractual requirements). Job Qualifications Required Qualification: - At least two years of clinical experience in managed care - including case management and home visit experience, or equivalent combination of relevant education and experience. - Registered Nurse (RN). License must be active and unrestricted in state of practice (NY). - Must reside in the state of New York or neighboring states (NJ, CT, parts of PA). Must have a NY state government ID. - Trained and knowledgeable in the New York Uniform Assessment System (UAS). - Must be able to travel to multiple boroughs via car or commuting public transportation. - Understands and applies principles of care management and person-centered planning. - Solid assessment skills. - Understands and applies coverage guidelines and benefit limitations. - Familiar with clinical needs and disease processes for chronic physical and behavioral illnesses. - Understands and adapts appropriately to issues related to member communication, cognitive or other barriers. - Organizational skills, and ability to prioritize and follow through on multiple projects in a timely manner. - Effective verbal and written communication skills. - Microsoft Office suite and applicable software programs proficiency. Preferred Qualification: - Certified Case Manager (CCM) or Chronic Care Professional (CCP). - Home care or long-term care experience. - Community support service experience accessing and using durable medical equipment (DME). - Experience in utilization review, concurrent review and/or risk management. - Bilingual or multi-lingual in Chinese (Mandarin or Cantonese), or Spanish.

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