Registered Nurse - Health Home, Fee-For-Service (RN, FFS)

DescriptionEliot Community Human Services provides a wide range of community based services for individuals and families of all ages in the areas of mental health, developmental disabilities, early intervention, counseling, substance abuse and youth programming.

We are seeking a dedicated and compassionate Nurse to join our team, committed to delivering exceptional care and support.

This role involves working closely with the Health Home team to ensure the effective coordination of personalized care plans and providing essential education and resources to our members.

Responsibilities : Provide insight and guidance regarding Member’s Person-Centered Care Plan (PCCP)Coordinate authorizations and service referrals with Commonwealth Care Alliance (CCA) Utilization Management and Clinical Operations Team and participate in care transitions and post discharge follow-up where indicatedDocument care coordination activities and data such as member and provider engagement, assessments, care plans, service referrals, care transitions work, and member demographic information, in CCA’s electronic platformsProvide education, consultation, and care coordination to active enrollees on the Health Home teamAssist enrollees with accessing community resources that will support and assist with addressing needs and health wellness effortsProvide oversight, guidance, and assistance to enrollees with understanding their medical conditionsMeet with enrollees and Health Home team members to discuss any medical diagnoses and conditions, causes, symptoms, complications, and treatment optionsProvide medication reconciliation following Eliot / CCA procedures related to enrollees on Health Home team assignmentReview all medical documentation for each enrollee as assigned on corresponding Health Home team and provide medical care consultation and coordination as neededAssist the Care Team, Health Home team, and enrollees by providing methods for ongoing assessment of symptoms and treatment effectiveness and identifying appropriate responses / actionsAct as liaison to medical providers for enrollees and assist enrollees in engagement with medical providers, recommendations, and other types of health / medical supportsDevelop working relationships with community medical providers, PCPs, and other community-based services in order to assist with coordinating medical care for enrollees on the team.

Assist with acting as a liaison to communicate medical issues and concerns to medical providers and ensuring the treatment team understands these concernsQualifications : Licensed registered nurse with at least two years of experience working with people with severe and persistent mental illnesses or providing medical coordination establishing supportive relationships and respect for treatment preferencesValid driver’s license and reliable transportationDemonstrates sound judgment and effective, solution-focused problem-solving skillsAbility to develop and maintain professional working relationships with consumers, staff, co-workers, and supervisorAbility to work effectively with diverse populations and cultural groupsQualificationsEducationPreferredBachelors or better in NursingLicenses & CertificationsRequiredRN