Assessment Nurse RN

US-NY-New York
Requisition ID
Department Name


Company Overview:   Healthfirst is a not-for-profit managed care organization sponsored by some of the most prestigious and nationally recognized hospitals and medical centers in New York. We are one of the fastest growing health plans in our area with over 900,000 diverse members and a network of more than 24,000 providers and 3,400 employees.   Our mission is to ensure that our members have superior healthcare and satisfaction; we significantly improve the health and wellness of the New York metropolitan area, all while driving down the costs. Employees shape our company and connect us to our communities. We look to recruit and retain intelligent, driven leaders who are passionate about healthcare and embody our five culture drivers:   - Dream Big, Plan Wisely - Break Down the Walls - Think Critically, Speak Up, Deliver with Pride - Inspire Through Trust, Lead By Example - Be Unstoppable    Position Summary:   The Assessment Nurse makes assessment visits at intervals required by the Department of Health (DOH) to determine enrollment, service needs and continued eligibility. This position coordinates with Care Management Team (CMT) to maintain a high level of efficient and effective individualized Care Management operations for SHP's managed long-term care plan (MLTCP), Healthfirst's Private Health Services Plan (PHSP), Complete Care, Fully Integrated Duals Advantage (FIDA) and Absolute Care. This position reports to Manager Assessment Nurse.     Healthfirst is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity or expression, veterans, disability status  or any other characteristic protected by law.


Duties and Responsibilities: 


  • Conduct enrollment assessments of prospective members and re-assessments of current members in their homes using the Uniform Assessment System (UAS); make enrollment decisions and continued eligibility determination by utilizing clinical expertise and critical thinking skills. As needed, will conduct assessments in settings other than home as needed, e.g. skilled nursing facilities 
  • Complete assessment of service needs at the request of the Care Team, Member's Family/Caregiver to determine service level(s) or need to adjust Service levels
  • Complete Patient Review Instruments/Screens and all required nursing assessments for active members to determine adjustments/updates in Care Plan and/or to assist with nursing home admission.
  • Liaison between the member and the Care Management Team; assesses home environment and psychosocial status
  • Maintain a paperless work environment, which includes compiling assessment package requirements and electronic archiving using Macess Exp Service Module.
  • Other duties as assigned 
  • Communicates with home care agencies and Care Management Team providing feedback regarding home care issues and the performance of Contract Nurses and Aides.
  • Provides grass roots, community-based training for frail population care including self-care techniques and prevention strategies.
  • Ensures that prospective members and significant others/responsible parties understand and are in agreement with enrollment in a managed long-term care plan


Minimum Qualifications:

  • New York State RN license.
  • Associate degree in nursing
  • Possess and maintain a valid New York State ID
  • Ability to travel within the NY Tri-State area, which primarily covers the 5 boroughs, Long Island and Westchester
  • Ability to travel to any area as needed within scheduling time frames - Car recommended for outer boroughs
  • U.S.-based work experience in one or more of the following areas:


Home Care 

Discharge Planning 

Case Management 

Medical Surgical Nursing  

  • Ability to communicate effectively in writing as appropriate for the needs of the audience.
  • Work experience assessing, planning and evaluating member's / patients care.
  • Work experience in navigating the Internet and using multiple computer applications and electronic documentation systems concurrently.
  • Basic MS Word and Excel using: edit, search, sort/filter, format and using already created pivot tables to locate information.
  • Ability to pass Uniform Assessment System training.


Preferred Qualifications: 



  • BS in nursing
  • Work experience using electronic patient health information (PHI) database usage (medical records database).
  • Work experience using multiple Medicaid managed care plan products such as, Family Health Plus (FHP), Eastern Benefits System (EBS), Federal Employee Program (FEP).
  • Experience working with a frail adult or elderly population with the ability to determine appropriate care plans and services for frail population, as well as, negotiate initial service plans so that members and families are in agreement.




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