Boston Senior Home Care Health Services Registered Nurse in Boston, Massachusetts
The Health Services Registered Nurse, in the Home Care program, functions as part of the interdisciplinary case management team, and participates in service planning for Home Care consumers. Responsibilities include clinical assessments of consumers to determine their medical eligibility for programs funded by the Executive Office of Elder Affairs (EOEA) and the Division of Medical Assistance (DMA). The nurse also performs in-home nursing assessments to determine the personal care needs of Home Care consumers. Primary Responsibilities: 1. Conducts nursing assessments and develops care plans for consumers referred for personal care, and reassesses annually, and as needed. 2. Participates in the interdisciplinary review of consumer records and provides consultation to case managers and other staff members regarding medical and nursing issues, insurance reimbursement, and community resources. 3. Collaborates with case managers to promote cost-effective community service plans. 4. Screens consumers for Waiver eligibility and enhanced Home Care service programs. 5. Reviews the initial assessment and service plan for all new Home Care consumers, and makes recommendations related to medical needs and special programs. 6. Performs clinical assessments and screenings for Home Care clients in the BSHC area for programs and services funded by DMA, including nursing facility and ADH. 7. Provides clinical assessments in nursing facilities to determine eligibility for MassHealth payment. 8. Reviews nursing facility screening requests from BSHC hospitals, and issues clinical determinations for same. 9. Collaborates with Money Follows the Person (MFP) Transition Coordinator to support return of nursing facility residents to the community. 10. Provides technical assistance and training in the screening process to hospitals, certified home health agencies, nursing facilities, and ADH staff. 11. Develops and implements training presentations on medical issues for staff and outside agencies. 12. Maintains collaborative relationships with agencies and institutions that serve BSHC clients, and maintains cooperative and effective working relationships with internal and external customers. 13. Participates in and assists with outreach programs. Competencies: ? Knowledge of the mental health, elderly, developmentally challenged and disabled populations. ? Strong assessment, independent caseload management, and interpersonal skills. ? Ability to communicate effectively and work collaboratively with consumers, families and co-workers. ? Solid computer skills and experience. ? Must be able to carry a 15 to 20 lb. load to consumer homes and travel to the community to perform visits at consumers? homes under all weather conditions. Required/Preferred Education and Experience ? Must have a Bachelor?s degree in Nursing or Associates of Science degree in Nursing and at least one year of clinical experience and/or nursing in a community or long term care setting; or a diploma in Nursing and two years of community-based nursing experience or long term care direct service experience. ? A valid Registered Nurse?s license from the Commonwealth of Massachusetts.