Nurse Rev II-Eligibility - Northeastern MA; home based client visits

Nurse Rev II-Eligibility - Northeastern MA (home based with client visits)

For Health Consulting at UMass Chan Medical School is seeking a Nurse Reviewer II to assess eligibility for individuals transitioning from nursing facilities, chronic disease, or rehabilitation hospitals to community settings under ABI and MFP Home and Community Based Waivers.

Under the general supervision of the Associate Director, the Nurse Reviewer II conducts in‑person assessments and reviews medical records to determine clinical eligibility, performs annual or interval assessments, evaluates community risks, and provides resource support while ensuring compliance with program guidelines and regulations.

• Contribute as an active member of a multi/inter‑disciplinary team to assess, plan, and evaluate clinical eligibility.
• Conduct on‑site assessments of applicants’ medical, functional, psychosocial, and supportive needs, determine community risks and mitigation strategies.
• Review and document all relevant information into data system applications per program guidelines.
• Utilize critical thinking to produce comprehensive, unbiased clinical assessments.
• Contact providers, state agency offices, and applicants to obtain necessary information and records.
• Maintain individual records documenting all encounters and contacts.
• Facilitate continuity of care by liaising with healthcare providers, hospitals, long‑term care facilities, and other partner organizations.
• Participate in public relations efforts, conferences, and meetings as needed.
• Maintain positive working relationships with participants, informal supports, provider organizations, consultants, and state agencies.
• Maintain confidentiality of all documents and correspondence per UMass Chan/For Health Consulting procedures and HIPAA regulations.
• Participate in performance improvement initiatives and apply quality improvement practices daily.
• Comply with departmental policies, procedures, and objectives.
• Comply with all health, safety, and program regulations and requirements.
• Participate in training and onboarding of new clinical staff.
• State‑wide travel is required.
• Perform other duties as required.

• Bachelor’s Level Degree in Nursing.
• RN with current licensure to practice in Massachusetts.
• 5–7 years of related work experience.
• Knowledge of applicable state regulations.
• Ability to travel statewide.
• Experience with Office applications and database use.

• Experience with disabled or long‑term care populations.
• Experience in Long‑Term Care, Home Care, Rehab, Brain Injury, Mental Health, Substance Abuse, and/or Disabilities.

Supervision received from Clinical Coordinator; supervision exercised:
None.

Remote/desk work with statewide travel required; concentration to Northeastern MA.

The University of Massachusetts Chan Medical School welcomes all qualified applicants and complies with all state and federal anti‑discrimination laws.