Enrollment Supervisor (RN)

The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.

Supervises and coordinates the Direct Marketing activities for Home First in accordance with New York State policy regulations. Evaluates referrals for appropriateness of membership. Conducts assessment of potential members in their home or hospital environment. Conducts marketing activities to potential members, physicians and community resource liasons. Develops, revises, coordinates and monitors the treatment plan of enrollees in conjunction with the enrollee and multidisciplinary team. Develops documentation to justify services prescribed in the care plan. Communicates effectively with Human Resources Administration (HRA) to insure enrollment documentation meets guidelines and advocates for member needs. Participates in quality management activities. Participates in community health care programs to promote HomeFirst and coordinate available community resources. Ensures all employees are oriented to their department/agency and job and provided with appropriate training, development and continuing education. Identifies potential risk issues and contributing factors in all areas of patient care, safety and legal matters, including potential for adverse publicity. managed care nurse, managed care rn, nursing, rn, nurse, care management

• Bachelor's of Nursing Degree from an NLN-Accredited School of Nursing.
• A minimum of one year nursing experience in Community Health or related field or minimum of two years nursing experience and a complete orientation to Home Care and to Public Health Nursing.
• Experience with outreach and enrollment for community-based chronic care setting preferred.
• Microsoft Word, Excel and Access.
• Active N.Y.S. license as Registered Professional Nurse and valid CPR certification.
• N.Y.S. driver's license and automobile or ability to efficiently utilize public transit system.
• Demonstrates critical-thinking and problem-solving skills.
• Effectively communicates by written and oral forms of communication.
• Initiates and undertakes self-directed activities, scheduling of visits.
• Demonstrates principles of customer service in all facets of job responsibilities.
• Familiarity with home care conditions of participation, NYSDOH regulations and Quality Standards of Clinical Practice.
• Demonstrates awareness of patient relation issues and strives to instill this sensitivity to others.
• Secures relevant information to identify potential problems and makes recommendations for solutions.