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Job description
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.
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.
Stays abreast of current and potential changes to federal, state and local statutes and regulations and applicable UAS and quality assurance standards. 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
Pay Range
USD $85,000.00 - USD $106,300.00 /Yr.
About Us
VNS Health has been committed to meeting the needs of New Yorkers for over 130 years. We're one of the largest nonprofit home- and community-based health care organizations in the country, and today, more than 11,500 team members work together to make a difference in the lives of more than 99,000 patients and members on any given day.
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.