RN, Clinical Eligibility

NeighborHealth PACE Enrollment And Eligibility

Responsible for completing the Minimum Data Set (MDS) with prospective PACE enrollees and also the ongoing annual renewals of all enrollees in the program.

Essential Duties & Responsibilities:

• Review Profile, Sales Plan & Medical Record of potential enrollee. Assess medical records for documented diagnosis, medications, physical and mental status.
• Contact potential enrollee to explain & reinforce the purpose of visit and schedule appointment.
• Visit potential enrollee and gather information to validate medical records and to complete MDS.
• Complete the MDS, sign, and have provider review and co-sign. Enter in Virtual Gateway.
• Upon collaboration with enrollment team for enrollment date, enter home care referrals into EPIC.
• In accordance with MDS due date log, review medical record of participants that are due one month prior to anniversary date.
• Collaborate with primary nurse to validate information gathered from medical record.

Qualifications and Requirements:

• Graduate of an accredited RN program; BSN preferred.
• Current Massachusetts license in nursing.
• Current BLS certification required.
• Exceptional triage assessment skills.
• Ability to communicate assessment findings efficiently, effectively and accurately in verbal and written formats.
• Bilingual a plus.

Pay Range:

$40/hr up to $60/hr based on experience

EEO & Accommodation Statement:

NeighborHealth is an equal employment/affirmative action employer. We ensure equal employment opportunities for all, without regard to race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity and/or expression or any other non-job-related characteristic. If you need accommodation for any part of the application process because of a medical condition or disability, please send an e-mail to View email address on click.appcast.io or call View phone number on click.appcast.io to let us know the nature of your request

Federal Trade Commission Statement: According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website. We do not ask or require downloads of any applications, or "apps." Job offers are not extended over text messages or social media platforms. We do not ask individuals to purchase equipment for or prior to employment.

E-Verify Program Participation Statement:

NeighborHealth participates in the Electronic Employment Verification Program, E-Verify. As an E-Verify employer, all prospective employees must complete a background check before beginning employment.