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Assessment Review Nurse more...
Location:Greenvale, NY
Company:Northwell Health
First posted:December 02, 2016 (last updated 1 week 3 days ago)
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Job Description

The position is responsible for the evaluation of clinical assessments, development, oversight, and approval of the assessment for MLTC Members. S/he will ensure that the assessment is appropriate and reflective of the member's health care needs. S/he will reevaluate clinical assessments, add any necessary changes to the assessments and provide oversight and supervision of the Assessment Nurses. Develop and provide necessary tools and education to ensure accurate and timely assessments. Monitor assessments in all regions for timeliness and adherence to guidelines established for the current assessment tool.

1. Evaluate clinical assessments from nursing and other disciplines of the MLTC Member. Experience in a supervisory position preferred.

  • Oversee clinical assessments for MLTC members
  • Supervises and instructs clinical staff, reevaluates clinical assessments and instructs on any necessary revision.
  • Utilizes knowledge of managed long term care services and regulations to ensure referrals have clinical and financial components.
  • Ability to effectively present information and respond to UAS Nurses, clients, customers and the general public.
  • Assists in identifying type services and supports that are needed by applicant prior to plan enrollment. This may include referring applicants to Certified Home health Agencies or other appropriate health care providers for interim care.

2. Enables and participates in the orientation of the staff regarding specific education and training.

  • Expands theoretical knowledge base, improving clinical techniques, and enhancing interpersonal skills.
  • Acts as a role model for MLTCP team members, patients and families.
  • Participates in quality improvement and utilization review activities.
  • Participates in staff meetings, conferences and other activities.
  • Establishes and maintains effective working relationships with patients, families and professional associates.
  • Demonstrates current and in-depth knowledge of clinical practice and available community resources, differentiating varying levels of care needs.
  • Serves as a liaison between the NYSDOH and the UAS Nurses.

3. Performs functions in a fiscally responsible manner consistent with the plan's mission and vision.

Performs related duties, as required. Qualifications

* Graduate from an accredited School of Nursing. Bachelor's Degree in Nursing, preferred.

* Licensed to practice as a Registered Professional Nurse in New York State.

* Minimum of one (1) year nursing experience, required. Home Care experience preferred.

Good computer skills.

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