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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in conducting medical and behavioral health assessments, ensuring compliance with HIPAA and state regulations, and developing person-centered care plans for vulnerable populations. Proficient in utilizing electronic health record systems and coordinating with healthcare providers to advocate for member needs.
Highest-signal resume keywords
Registered Nurse (RN) LicenseClinical AssessmentsCare CoordinationMassHealth ProgramsPerson-Centered Care Planning
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Clinical AssessmentsBehavioral Health EvaluationsLevel of Care DeterminationsUtilization ReviewsService Plan DevelopmentDocumentation in Electronic SystemsStandardized Assessment Tools (UCA, TTT)Compliance with State and Federal RegulationsCare Plan RevisionAdvocacy for Member Independence
Soft Skills
CollaborationCommunicationEducationProblem-SolvingTeam Support
Tools & Technologies
Microsoft Office ApplicationsElectronic Health Record SystemsHigh-Speed Internet Service
Certifications & Qualifications
Registered Nurse (RN) License in Massachusetts
Industry Keywords
Person First StandardsHIPAA GuidelinesLong-Term Services and Supports (LTSS)Home and Community-Based Services (HCBS)Community-Based Services
About the role
Key responsibilities & impact- Complete medical and/or behavioral health assessments in accordance with contract requirements
- Conduct on-site, video, and/or telephonic assessments to determine needs, eligibility, and level of care
- Interpret clinical and program guidelines to support accurate and consistent determinations
- Escalate complex and non-standard cases that are exceptions to policies
- Perform duties in compliance with Person First standards, HIPAA guidelines, and company confidentiality policies
- Serve as an internal resource to team members
- Travel to client, consumer or program locations to perform in-person assessments exceeding 50% of the workweek
- Conduct assessments using standardized tools (UCA, TTT)
- Develop and manage service plans for complex or high-acuity members
- Coordinate with healthcare providers, case managers, and community resources
- Evaluate eligibility for referrals to other professionals or agencies
- Maintain compliance with state and federal regulations, Medicaid/LTSS program guidelines, and electronic health record systems
- Collaborate with care teams to revise care plans as needs change
- Educate members, families, and caregivers on available services and options
- Document assessments and care activities for billing, compliance, and quality reporting
- Advocate for members to remain in preferred living environments and maintain independence
- Support Massachusetts residents through Maximus's Public Assessors Option for MassHealth LTSS programs
Requirements
What you’ll need- Active, unencumbered Registered Nurse (RN) license in the state of Massachusetts
- Minimum of two (2) years of relevant post-graduate clinical experience as a Registered Nurse
- Experience working with vulnerable populations, including individuals with behavioral health needs, intellectual and developmental disabilities (I/DD), and those requiring long-term services and supports (LTSS)
- Experience conducting clinical or functional assessments in home or community-based settings, such as behavioral health evaluations, level of care determinations, or utilization reviews
- Knowledge of community-based services, care coordination, and person-centered care planning
- Familiarity with MassHealth programs, LTSS, and Home and Community-Based Services (HCBS) waiver programs
- Proficiency in Microsoft Office applications
- Experience documenting assessments in electronic systems
- Travel on-site to client, consumer or program locations for more than 50% per week
- Reliable high-speed internet service
- Minimum 20 Mbps download speeds/50 Mbps for shared internet connectivity
- Minimum 5 Mbps upload speeds
- Private and secure workspace
Benefits
Comp & perks- $1,000 sign-on bonus
- Eligible business travel reimbursed at the current IRS federal mileage rate of 76.0 cents per mile
- Monday–Friday schedule (8:00 AM–5:00 PM)
- Independence to manage your own daily schedule
- Performance bonus opportunities
- Professional growth and tuition reimbursement
- Comprehensive benefits
- 401(k) with company match
- Health insurance coverage
- Life and disability insurance
- Retirement savings plan
- Paid holidays
- Paid time off
- Company-issued computer equipment
- Hybrid remote schedule