RN / LPN

Qualifications for this position:

Professional Characteristics

• The registered nurse must be fully licensed by the Massachusetts Board of Registration in Nursing
• The registered nurse must have at least two years' recent experience in the direct care of the elderly or disabled adults
• Demonstrate the ability to work both independently and within a team setting
• Able to meet timelines for submission of all assigned duties and tasks
• Must possess a valid Massachusetts driver's license and meet the company's driver insurance standards and maintain a safe driving record

Must have an acceptable CORI (criminal record assessment)

Personal Characteristics

• Professional oral and writing skills necessary for developing and implementing care plans and notes
• Proficient working knowledge and experience using MS Word, MS Excel, and Office 365
• Must have excellent work habits
• Self-motivation, organized and flexible
• Commitment to improve care in underserved populations
• Collaborative work style; relationship building; entails meeting directly with members, their families and providers in home and office settings
• High level of accountability
• Must have a reliable vehicle to travel throughout the program's geographic areas

Ability to speak multiple languages preferred [i.e. Spanish, Portuguese, Creole, Vietnamese)

Essential Job Function:

The responsibilities of the registered nurse include:

1. complete and sign the designated screening tool as required under 130 CMR 408.416(C) for MassHealth payment;

2. complete the MDS-HC or CDS and other nursing assessments and coordinate all other applicable clinical assessments;

3. develop and review on an ongoing basis each member's AFC plan of care;

4. select, train, evaluate, and supervise AFC caregivers in conjunction with the care manager;

5. review the physician summary;

6. monitor the health status of all members to ensure that all needed AFC is properly delivered;

7. report changes in the health status of any member to the member's physician;

8. periodically review AFC caregiver logs;

9. conduct on-site visits with each member at the qualified setting bimonthly (alternating with the bimonthly visit by the care manager) for Level I, and monthly or more often as the member's condition warrants for Level II;

10. complete a nursing progress note corresponding with each on-site visit or encounter, or more often as the member's condition warrants;

11. submit a semiannual health-status report to the member's primary care physician;

12. plan for and implement discharges from the AFC program;

13. conduct an orientation for each AFC caregiver before the AFC caregiver begins personal care; and

14. Provide ongoing training to AFC caregivers on health and aging.