Registered Nurse- Ambulatory Care Nursing

Works under the general supervision of the Marketing, Enrollment and Network Director, The Eligibility RN works together with the Business Development Representatives and Enrollment Representatives in order to determine the eligibility of future participants for the High Desert PACE Program.

The Enrollment RN is a member of the outreach and enrollment team, who works closely with the physician, social worker as well as other outreach and enrollment team members
Physical attendance at the High Desery PACE facility and/or a High Desert PACE participant home is essential to performing the job duties
Works closely with the Business Development and Enrollment Development Department to determine if prospective PACE participants meet Title 22 Guidelines for Nursing Level of Care, required for all PACE participants.
Schedules and conducts home visits and/or center-based clinic appointments, to make level of care assessments to determine eligibility
Conduct initial nursing assessments, including but not limited to nursing evaluation, functional assessment, and home safety evaluation, in prospective High Desert PACE participants' homes, to determine if they meet PACE eligibility requirements
Promptly prepare documentation from home visits, submit to CA State Level-of-Care (LOC) nurse for review and reply to questions to expedite the review process for participants
Track and oversee the annual State level-of-care review process
Collaborate with the interdisciplinary team (IDT) and outreach & enrollment (O&E) team
Completes eligibility referral document, in close collaboration with the Organization’s Primary Care Physician, and compiling supporting documentation for application to the State for enrollment.
Works closely with the California Department of Health Care Services (DHCS) PACE Nurse Assessor to make eligibility decisions about prospective new PACE participants
Managing semi-annual audits of participant’s medical records conducted by the DHCS PACE Nurse Assessor
Completes semi-annual level of care redetermination for all participants to be submitted to the DHCS PACE Nurse Assessor
Participates and assists with outreach programs
Participates in case management of peer review of client records and provides consultation to case managers and other staff members regarding medical and nursing issues
Education & Training

• Associate degree from accredited nursing school required.
• Current Registered Nurses License in state in which working
• 3 years health care experience with emphasis in geriatrics
• Knowledge of physical, mental and social needs of frail older adults.

Effective skills in physical assessment and chronic disease management for frail older adults.
Computer proficiency.
Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
Physical attendance at the High Desery PACE facility and/or an High Desery PACE participant home is essential to performing the job duties
Requires use of personal vehicle.
May require use of personal cell phone for business purposes (may be eligible for stipend).