Enrollment Coordination Nurse RN

Company: Harbor Health Services
Location: Brockton
Posted on: September 12, 2023

Job Description:

OFFERING A $5000 SIGN ON BONUS!*Harbor Health Services is an innovative, growing, mission-based organization that lives, serves and collaborates with our community members to achieve our mission to help individuals reach their full potential through access to local, affordable services that promote health. Harbor provides medical, behavioral health, dental, and support services to more than 34,000 patients in Boston, the South Shore, and Cape Cod. Harbor Health also operates two Programs for All-Inclusive Care for the Elderly in Mattapan and Brockton, providing comprehensive healthcare, transportation and social services for more than 450 frail elders who continue to live with dignity and independence in the community and a Woman, Infants and Children (WIC) Nutrition Program. To help further the mission of Harbor, we are looking for an extremely talented Enrollment Coordination Nurse to join our team at the Elder Service Plan (ESP) in Brockton, MA.Harbor Health offers an excellent, comprehensive benefits package including Health, Dental, Vision, Life, & Disability insurance, 403b Savings Plan, Generous Paid Time Off plus 11 additional Holidays and much more! Role:The ESP Enrollment Coordination Nurse is passionate about providing quality care to the geriatric population who choose to live in their homes instead of a nursing home. This role serves as a clinical liaison between prospective PACE participants and caregivers, the PACE enrollment team, and the PACE Interdisciplinary Team. The Enrollment Coordination Nurse functions as an integral part of the clinical enrollment team to prioritize, organize, and enact what is needed to meet potential participants individualized needs. The Enrollment Coordination Nurse serves as primary clinical reviewer of all potential enrollees to HHSI Elder Service Plan PACE with the goal of increasing enrollment while ensuring each individual enrolled is safe to live in their home with PACE services. The Enrollment Coordination Nurse provides all nursing functions according to Massachusetts Law and HHSI policy and procedures.Responsibilities: The Enrollment Coordination Nurses primary function is the successful clinical transition of new enrollees into the PACE model of care. Reviews Risk Stratification Assessment tool and categorizes potential enrollees according to set criteria and communicates these findings to enrollment team.Reviews medical documentation of potential enrollees and notes particular concerns and escalates as appropriate; reviews may include medical record documentation, collaboration with PACE staff, phone calls to potential enrollees, and in-person assessments, depending on the potential enrollees level of risk.Determines need for and facilitates additional assessment of prospective applicants, including home safety evaluations, determination of home care needs, Day 1 service requirements, etc.Engages with potential enrollee and/or family via phone conducts in-person visits to home as necessary to address pre-enrollment clinical concerns to assess PACEs ability /suitability for meeting client needs and communicates PACE scope, processes, and program expectations. Assists with development of initial service plan, which is given to potential enrollee and/or care partners. Enhances communication and collaborative relationships with IDT to improve initial coordination of care and facilitate service delivery.Presents and discusses initial needs assessment intake with IDT and supports questions during first days of enrollment as needed.Collaborates with IDT to assess prospective participants ability to remain living safely in the community with PACE services.Meets regularly, and frequently collaborates with new enrollee clinical panel to review prospective new enrollees. May assist in Care Coordination and/or Utilization Management with discharge planning and transitions of care of hospitalized participants.Provides coverage during planned/unplanned absences of Care Coordination and/or Utilization Management.Interacts with client and family members in a manner that adheres to the highest standards of care and professionalism.Builds trust and fosters smooth relationships with clients and their families and acts as ambassador and educator about PACE.Promotes patient confidentiality and right to privacy and cooperates with Medical Records staff to ensure effective return and retrieval of patient records.Continuously updates his/her own clinical and professional knowledge and skills through formal and informal educational experiences.Requirements: Associate Degree in Nursing, BSN preferredCurrent MA RN License, current BLS (Basic Life Support for Health Care Providers) Certification requiredTwo (2) or more years of experience in a home care, acute or long-term care settingOne year of experience working with geriatric patients requiredHomecare experience preferredCommunity health or ambulatory care experience helpfulHighly developed geriatric assessment and clinical skillsStrong knowledge of medical/psychiatric diagnosis and treatments Experience and comfortability with individuals from diverse socio-cultural backgroundsExcellent communication and customer service skillsExcellent critical thinking, problem-solving and organizational skills.Computer literacy (Microsoft Office 365 applications with a focus on Word, Excel and Outlook)Experience with Electronic Medical Record preferred Must be able to travel to multiple sites, including patients home and other settings, in a timely mannerAll qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status. *$5000. Sign On Bonus offered, $2500 on hire and $2500 after 90 days in good standing, former employees of HHSI not eligible.

Keywords: Harbor Health Services, Brockton , Enrollment Coordination Nurse RN, Healthcare , Brockton, Massachusetts