Description
Maximus is seeking a compassionate Clinical Assessor, Registered Nurse to make a meaningful impact by helping individuals access the care and services they need to live safely and independently in their communities. In this field-based role, you'll conduct comprehensive in-person assessments in members' homes, hospitals, and other community settings, evaluate medical, functional, behavioral health, and social needs, develop person-centered service plans, and collaborate with healthcare providers and community partners to coordinate care. You'll also educate members and caregivers on available resources, advocate for vulnerable populations, and maintain accurate documentation while ensuring compliance with Medicaid and LTSS program requirements. This position requires independent management of a daily travel schedule throughout the assigned region during standard business hours (Monday–Friday, 8:00 AM–5:00 PM). If you're passionate about improving lives through community-based care and enjoy working independently while making a difference every day, we'd love to hear from you!
**Travel is required Monday–Friday to complete assigned assessments within designated regions
About the Program
The Commonwealth of Massachusetts Executive Office of Health and Human Services (EOHHS), through the MassHealth Office of Long-Term Services and Supports (LTSS), provides a robust system of care for individuals of all ages with disabilities and chronic conditions. The program is designed to help Massachusetts residents live with independence and dignity, participate in their communities, and improve their overall quality of life.
As the Public Assessors Option (PAO), Maximus provides education to providers, conducts comprehensive in-person assessments, and offers call center support for the following LTSS programs:
- Adult Day Health (ADH)
- Adult Foster Care (AFC)
- Group Adult Foster Care (GAFC)
- Personal Care Attendant (PCA)
- As the PAO, Maximus serves as a point of entry for LTSS inquiries and initial contacts while conducting timely, high-quality, consistent, and accurate assessments to determine clinical eligibility for these programs
Why Maximus?
- Work/Life Balance Support - Flexibility tailored to your needs
- Competitive Compensation -Bonuses based on performance included
- Comprehensive Insurance Coverage - Choose from various plans, including Medical, Dental, Vision, Prescription, and partially funded HSA. Additionally, enjoy Life insurance benefits and discounts on Auto, Home, Renter's, and Pet insurance
- Future Planning - Prepare for retirement with our 401K Retirement Savings plan and Company Matching
- Paid Time Off Package - Enjoy PTO, Holidays, and extended sick leave, along with Short and Long Term Disability coverage
- Holistic Wellness Support - Access resources for physical, emotional, and financial wellness through our Employee Assistance Program (EAP)
- Recognition Platform - Acknowledge and appreciate outstanding employee contributions
- Tuition Reimbursement - Invest in your ongoing education and development
- Employee Perks and Discounts - Additional benefits and discounts exclusively for employees
- Maximus Wellness Program and Resources - Access a range of wellness programs and resources tailored to your needs
- Professional Development Opportunities-Participate in training programs, workshops, and conferences
- Licensures and Certifications-Maximus assumes the expenses associated with renewing licenses and certifications for its employees
Essential Duties and Responsibilities:
- Responsible for completing medical and/or behavioral health assessments within contract requirements
- Conducts on-site, video call and/or telephonic assessments to determine an individual’s needs for services and supports, eligibility, level of care or related outcome
- Perform all job duties in compliance with Person First standards, HIPAA guidelines, and company confidentiality policies and procedures
- Travel may be required based on program contract requirements
- Performs other related duties as assigned
- Conduct assessments using standardized tools (UCA, TTT) to identify medical, functional, and social needs
- Develop and manage service plans for complex or high-acuity members, coordinating with healthcare providers, case managers, and community resources
- Evaluate eligibility for recommended 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, ensuring alignment with member goals
- Provide education to members, families, and caregivers on available services and options
- Document assessments and care activities accurately to support billing, compliance, and quality reporting
- Advocate for members to help them remain in preferred living environments and maintain independence
Minimum Requirements:
- Current Registered Nurse (RN) license valid in the state of practice is required
- High School Degree or equivalent required
- Minimum 2 years of clinical experience required
- An 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
Home Office Requirements:
- Maximus provides company-issued computer equipment
- Reliable high-speed internet service
- Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
- Minimum 5 Mpbs upload speeds
- Private and secure workspace
