Sr Clin Admin Nurse Nurse - MA - Full-time / Part-time

There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Nursing here isn't for everybody. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Start doing your life's best work.(sm) Previous experience and strong proficiency with completing an MDS-HC assessment with minimal supervision with 95% or greater approval without revisions or modifications.
 
Reporting to the Associate Director of Medical and Clinical Operations, the Minimum Data Set- Home Care (MDS-HC) Nurse is responsible for the review and submission of data captured on the MDS-HC assessment by the field-base case management team to the Massachusetts Executive Office of Health and Human Services (EOHHS).Primary Responsibilities:

 Collaborates with the field-based case management team to review information collected in the MDS-HC assessment against other sources of clinical information such as the health plan's Centralized Enrollee Record (CER), CareOne to ensure that a clear and accurate clinical scenario is presented to EOHHS for review and determination of appropriate rating categories
Ensures that all MDS-HC assessments are submitted to EOHHS in a timely manner per department policies and procedures
Acts as a subject matter expert (SME) on the MDS-HC assessment and is responsible for working with the MDS-HC Nursing Team to develop and deliver training to staff as necessary
Attends activities including social and other professional organizations
Keeps current with all clinical affairs trends, policies, practices, and workflows
Maintains professional growth and development through self-directed learning activities and involvement in professional, civic, and community organizations
Other duties as assigned

Requirements:

Requires a valid, unrestricted MA state Registered Nurse license.
1+ years of experience as a Registered Nurse, preferably in Home Care or Managed Care 
Basic level of experience with Microsoft Word, with the ability to navigate a Windows environment
 Additional Preferred Assets:

Bachelor's degree preferred
Experience with MDS-HC assessment highly preferred
1+ years of case management experience, preferably field-based and with a focus on geriatrics
Experience in Medicaid, Medicare Advantage, and home and community based service delivery
 
Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.SM
Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.