Job description

The basic function of the Clinical Assessment and Evaluation RN, (CAE RN) is to screen clients for Nursing Home, Adult Day Health, and 2176 Waiver eligibility. Assess clients for personal care. Provide nursing consultation to case managers, clients and providers of personal care.

Responsibilities:

• Do on site assessments for Nursing Home (SNF), Adult Day Health (ADH) and 2176 Waiver screenings as needed in our service area.

• Assess clients for personal care and confer with Care Managers about the client’s total care plan.

• CAE RN will have the ability to determine medical eligibility for all CAE screenings: SNF, ADH, 2176 Waivers, Enhanced Community Options Program (ECOP), and Community Choices.

• Fill out the CDS RN 3 in SAMS to assess for personal care.

• Monitor and supervise the appropriateness, frequency and quality of personal care service via an annual visit.

• Attend meetings with providers, case conferences and be available for consultations as necessary.

• In conjunction with Care Managers, (CM), CAE RN determines client appropriateness for specific service options, promotes cost effective service substitutions, and establishes the frequency, scope and duration of services.

• Participates in assessment and interdisciplinary review of cases; consults with involved caregivers and documents findings.

• Advocate for HC clients with HMO’s, VNA’s and MD’s.

• Provides consultation to providers and other community agencies.

• Maintains records and prepares reports as requested, including case summaries for Department of Medical Assistance hearings.

• The CAE RN is responsible for maintaining collaborative relationships among community agencies and institutions that service medical and social needs of clients.

• Perform, as needed, 2176 Waiver yearly re-determination via home visit or by contacting the CHHA or ADH for medical information.

Essential Functions/Qualifications:

• Must have valid/current RN license in the state of Massachusetts.

• Motor vehicle and Valid Driver’s license; maintain minimum insurance liability on vehicle and complete motor vehicle driving record check

• Must have minimum of one year of clinical experience.

• Knowledge of MassHealth programs

• Knowledge and experience with long term care and social service delivery system; community resources

• Familiarity with state wide health care network