TERRITORY IS Bronx, Manhattan OR Westchester
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.
General Job Information
Uniform Assessment System RN
Clinical Services Group
United States of America
United States of America (Exempt)
Recruiting Start Date
Date Requisition Created
Associates: Nursing (Required), Bachelors: Nursing
License and Certifications
Registered Nurse, State and/or Compact State Licensure
License and Certifications
Certified Case Manager
Care Mgmt, CCP
Chronic Care Professional
Other Job Requirements
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.
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.
Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled
Magellan Health Services