Fallon Massachusetts Jobs

mobile fallon logo

Job Information

Fallon Health ACO Nurse Liaison in Worcester, Massachusetts

Overview

About Fallon Health

Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation’s top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit fallonhealth.org.

Brief Summary of Purpose :The ACO RN Liaison focuses on establishing face to face engagement with ACO Partner and providers and promotes the Fallon ACO products. Responsibilities include working closely with the ACO Partner staff to educate providers on the Model of Care, and be a resource for member care coordination.The ACO RN Liaison works collaboratively with all community partners representing Fallon Health in a collaborative positive way. This position requires ability to drive to our ACO Partner groups - Wellforce Care in North Boston/Lowell area several times a week. Rest of work week is remote work.

Responsibilities

Performance Requirements including but not limited to:

  • Excellent communication and interaction with members and providers via telephone and in-person

  • Excellent organizational skills and ability to multi-task

  • Appreciation and adherence to policy and process requirements

  • Independent learning skills and success with various learning methodologies including but not limited to: self-study, mentoring, classroom, and group education

  • Exceptional customer service skills and willingness to assist ensuring timely resolution

  • Knowledgeable about community resources available to assist the member population in the community and long term care settings and demonstrated willingness to seek resources and expand knowledge to assist the population

  • Knowledgeable about insurance regulatory and accreditation requirements

  • Effective case management and care coordination skills

  • Physician and other health care provider interaction and other communication including but not limited to face to face communication

  • Ability to lead case management rounds with Clinical Integration staff, providers and others involved in member’s care

  • Ability to mentor and train others

  • Proficient in software systems including but not limited to Microsoft Office Products – Excel, Outlook, and Word

  • Proficient in manipulating Excel spreadsheets to manage work and exposure and familiarity with pivot tables

Competencies:

  • Demonstrates commitment to the Fallon Health Mission, Values, and Vision

  • Specific competencies essential to this position:

  • Problem Solving

  • Asks good questions

  • Critical thinking skills, looks beyond the obvious

  • Adaptability

  • Handles day to day work challenges confidently

  • Willing and able to adjust to multiple demands, shifting priorities, ambiguity, and rapid change

  • Demonstrates flexibility

  • Written Communication

  • Is able to write clearly and succinctly in a variety of communication settings and styles

Qualifications

Graduate from an accredited school of nursing mandatory and a Bachelors (or advanced) degree in nursing or a health care related field preferred.

License: Active, unrestricted license as a Registered Nurse in Massachusetts; current Driver’s license and a vehicle to be used for home visits

Certification : Certification in Case Management strongly desired

Other: Satisfactory Criminal Offender Record Information (CORI) results

Experience:

  • 4+ years of clinical experience as a Registered Nurse managing chronically ill members or experience in a coordinated care program required

  • Experience working face to face with members and providers required

  • Experience with telephonic interviewing skills and working with a diverse population, that may also be Non-English speaking, required

  • Home Health Care experience preferred

  • Familiar with NCQA case management preferred

PM16

Location US-MA-Worcester

Posted Date 3 weeks ago (11/21/2019 2:10 PM)

Job ID 5801

# Positions 1

Category Nursing

DirectEmployers