Overview

Audits UAS assessments for all VNS Health Plans product lines to ensure quality and regulatory compliance. Conducts change in condition assessments, as well as other assessments as needed.

Works under general supervision.

Compensation :

$85,000.00 - $106,300.00 Annual

What We Provide

• Referral bonus opportunities
• Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays
• Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability
• Employer-matched retirement saving funds
• Personal and financial wellness programs
• Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care
• Generous tuition reimbursement for qualifying degrees
• Opportunities for professional growth and career advancement
• Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities

What You Will Do

• Reviews Uniform Assessment System (UAS) assessments completed by internal staff and external vendors to ensure documentation is complete, accurate, consistent and appropriate.
• Compares Aide Task Service Plan (ATSP) versus UAS responses to ensure validity / accuracy of determined home health aide hours.
• Reviews audit reports to identify trends and areas for improvement. Makes recommendations for change, as appropriate.
• Conducts comprehensive clinical, psycho-social, and financial risk assessments of members as needed. Maintains member confidentiality and compliance with HIPPA requirements.
• Completes required assessment form (UASNY) and other VNS Health Plans documents within the required timeframes and in accordance with VNS Health Plans established policies and procedures and State and Federal guidelines and regulations.
• Identifies appropriate home health aide hours based on Personal Care Assessment / other appropriate tool and program guidelines.
• Participates and assists in departmental studies and projects as assigned.

Makes recommendations to department leadership based on changes.

Participates in special projects and performs other duties as assigned.

Qualifications

Licenses and Certifications :

• License and current registration to practice as a Registered Professional Nurse in New York State Required
• Valid driver's license or NYS Non-Driver photo ID card may be required as determined by operational needs.

Education :

• Associate's Degree in Nursing Required
• Bachelor's Degree in Nursing Preferred
• Master's Degree in Nursing Preferred

Work Experience :

• Minimum two years' nursing experience in an institution, Home Care or Managed Long Term Care Program Required
• Experience conducting enrollments Preferred
• Strong knowledge of federal and state health care regulations related to Medicare, Medicaid, managed care, and long term care Preferred
• Effective oral, written and communication skills Required
• General managerial experience and negotiation skills Preferred
• Proficiency in personal computer operations including MS Office applications Required
• Bilingual skills may be required as determined by operational needs Preferred
• Knowledge of geriatric population Preferred

Last updated : 2024-05-10