Activate Care

Manager

• Serve as the embedded clinical resource for a team of CHWs
• Provide real-time case consultation, clinical guidance, and side-by-side assistance to CHWs on complex member situations.
• Own the daily clinical audit of the Transitions of Care (TOC) queue, utilizing health plan guidelines to appropriately triage complex Level 2 cases and route clean Level 1 referrals to the CHW team.
• Identify members whose needs exceed the CHW scope and step in directly or coordinate the appropriate clinical hand-off.
• Lead and represent the organization in monthly joint Level 1 and Level 2 case conferences with health plan clinical leadership.
• Coach and mentor CHWs to strengthen engagement skills, recognition of behavioral health and risk indicators, and appropriate escalation.
• Oversee the end-to-end Medicaid claims cycle for the clinical team, including pre-submission documentation reviews, code utilization tracking, and denial management.
• Identify and execute direct-billing opportunities for licensed behavioral health interventions and assessments allowable under Nevada Medicaid.
• Help develop and reinforce team workflows, clinical protocols, and best practices in partnership with leadership.
• Conduct biopsychosocial and behavioral health assessments to identify member needs, strengths, and risks.
• Provide brief, evidence-based clinical intervention (such as motivational interviewing and solution-focused techniques) and warm hand-offs to ongoing behavioral health treatment.
• Contribute clinical expertise to individualized care plans as part of the interdisciplinary care team (ICT).
• Apply trauma-informed and culturally responsive practice across a diverse, predominantly Medicaid population.
• Serve as the team's escalation point for members presenting with behavioral health, safety, or crisis concerns.
• Conduct risk assessment and coordinate appropriate crisis response, follow-up, and linkage to emergency or stabilization services.
• Support CHWs through difficult situations in the field and debrief afterward.
• Partner with CHWs to connect members to behavioral health services, community resources, and supports addressing social determinants of health, including housing, food, transportation, employment, and benefits.
• Build and maintain relationships with community-based organizations and behavioral health providers across the assigned territory.
• Coordinate with PCPs, care managers, and health-plan partners to close gaps in care.
• Maintain timely, accurate clinical documentation in the care management platform.
• Ensure work meets Medicaid, state, NCQA, and organizational clinical and privacy (HIPAA) standards.
• Contribute to quality initiatives and outcome tracking for the team.
• Other duties as assigned

Clinical Case Manager

General

• Engage with members in their homes and other community settings to complete assessments, with mindfulness of the cultural and linguistic needs of each member.
• Perform required assessments on a timely basis as assigned under the contract, including Uniform Core Assessments (UCA), Functional Assessments (FA), and Comprehensive Assessments, evaluating each member's physical, cognitive, and functional status.
• Document assessments in the health plan's care management platform (GuidingCare) following the provided workflows and resource guides.
• Send a SOAP note to the assigned health plan Care Manager upon assessment completion.
• Submit accurate, complete documentation within 48 hours of each assessment and maintain a high completeness and quality standard as measured through the health plan's review and audit.
• Complete required training and ongoing training to maintain system access.
• Routinely travel to members' homes and, or community settings to conduct assessments.
• Report abuse, neglect, or exploitation of older adults and adults with disabilities as a mandated reporter, as required by state law.
• Follow field-safety practices for independent in-home visits and escalate clinical or safety concerns appropriately.
• Adhere to all applicable regulatory, privacy (HIPAA), NCQA, and care management standards.
• Maintain licensure and or certifications.
• Other duties as assigned.

Registered Nurse, Home Health Assessments

• Engage with members in their homes and other community settings to complete assessments, with mindfulness of the cultural and linguistic needs of each member.
• Perform required assessments on a timely basis as assigned under the contract, including Uniform Core Assessments (UCA), Functional Assessments (FA), and Comprehensive Assessments, evaluating each member's physical, cognitive, and functional status.
• Document assessments in the health plan's care management platform (GuidingCare) following the provided workflows and resource guides.
• Send a SOAP note to the assigned health plan Care Manager upon assessment completion.
• Submit accurate, complete documentation within 48 hours of each assessment and maintain a high completeness and quality standard as measured through the health plan's review and audit.
• Complete required training and ongoing training to maintain system access.
• Routinely travel to members' homes and/or community settings to conduct assessments.
• Report abuse, neglect, or exploitation of older adults and adults with disabilities as a mandated reporter, as required by state law.
• Follow field-safety practices for independent in-home visits and escalate clinical or safety concerns appropriately.
• Adhere to all applicable regulatory, privacy (HIPAA), NCQA, and care management standards.
• Maintain licensure and/or certifications.
• Other duties as assigned.

• Engage with members in their homes and other community settings to complete assessments, with mindfulness of the cultural and linguistic needs of each member.
• Perform required assessments on a timely basis as assigned under the contract, including Uniform Core Assessments (UCA), Functional Assessments (FA), and Comprehensive Assessments, evaluating each member's physical, cognitive, and functional status.
• Document assessments in the health plan's care management platform (GuidingCare) following the provided workflows and resource guides.
• Send a SOAP note to the assigned health plan Care Manager upon assessment completion.
• Submit accurate, complete documentation within 48 hours of each assessment and maintain a high completeness and quality standard as measured through the health plan's review and audit.
• Complete required training and ongoing training to nd maintain system access.
• Routinely travel to members' homes and, or community settings to conduct assessments.
• Report abuse, neglect, or exploitation of older adults and adults with disabilities as a mandated reporter, as required by state law.
• Follow field-safety practices for independent in-home visits and escalate clinical or safety concerns appropriately.
• Adhere to all applicable regulatory, privacy (HIPAA), NCQA, and care management standards
• Maintain licensure and or certifications
• Other duties as assigned.

• Engage with members in their homes and other community settings to complete assessments
• Perform required assessments on a timely basis including Uniform Core Assessments (UCA), Functional Assessments (FA), and Comprehensive Assessments
• Document assessments in the health plan's care management platform (GuidingCare)
• Send a SOAP note to the assigned health plan Care Manager upon assessment completion
• Submit accurate, complete documentation within 48 hours of each assessment
• Complete required training and maintain system access
• Routinely travel to members' homes and community settings to conduct assessments
• Report abuse, neglect, or exploitation of older adults and adults with disabilities
• Follow field-safety practices for independent in-home visits
• Adhere to all applicable regulatory, privacy (HIPAA), NCQA, and care management standards
• Maintain licensure and or certifications
• Other duties as assigned.

Procurement

• Source and identify qualified Registered Nurses (RN) candidates through job boards, social media platforms, networking, and other sourcing channels.
• Partner closely with the recruiting team to understand staffing needs, position requirements, and hiring priorities.
• Build and maintain a talent pipeline for current and future nursing recruitment needs.
• Utilize applicant tracking systems (ATS) and recruiting tools to track activity and maintain accurate candidate records.
• Schedule and coordinate candidate interviews with recruiters and hiring managers.
• Maintain consistent communication with candidates throughout the interviewing process to ensure a positive candidate experience reflecting the organization’s values and culture.
• Provide regular updates on pipeline activity and candidate flow.
• Assist with special recruiting projects and hiring initiatives as needed.
• Other duties as assigned.

Sourcing Specialist, Registered Nurses – Temp

• Conduct in-person assessment visits and clinical exams, including relevant screenings within assigned territory.
• Perform medication coaching and reconciliation, identify adherence concerns, and provide patient education on acute and chronic diseases.
• Complete screeners such as PHQ-9, EASI, Audit, and DAST, and Minimum Data Set- Home Care as needed.
• Prioritize and escalate members with urgent needs to RN Supervisor or manager promptly.
• Use electronic health record and claims systems to document and track member interactions and care needs.
• Ensure timely referrals to behavioral health and long-term services as appropriate.
• Manage scheduling and tracking of assessments to ensure timely completion.
• Participate in quality improvement activities and maintain clinical competencies.
• Maintain effective communication and a constructive work environment with team members.
• Comply with organizational policies, privacy regulations, and documentation standards.
• Provide clinical assessments via telehealth when appropriate.
• Continuously assess member’s engagement within the designated care pathway, and determine program fit.
• Collaborate with care, decision makers to ensure program alignment.
• Other duties as assigned.

Part-Time RN, MDS Assessments

Field RN – MDS Assessments

Part-Time Field RN, MDS Assessments

Part-Time Field RN – MDS Assessments

• Coordinate and maintain the daily schedules for approximately five home assessment nurses in Boston, Springfield, and Worcester Massachusetts.
• Reach out by phone to schedule and confirm member visits, including initial and follow-up assessments.
• Optimize scheduling by considering geography, nurse availability, and member needs to minimize travel time and maximize efficiency.
• Update scheduling and EMR systems in real time with accurate appointment and member information.
• Communicate promptly with nurses and leadership regarding schedule changes, urgent member needs, or cancellations.
• Track assessment completion rates and follow up on outstanding appointments.
• Document outreach attempts, scheduling details, and special instructions in the appropriate systems.
• Collaborate with internal teams to address barriers to scheduling or member engagement.
• Provide excellent customer service to members and their caregivers while maintaining confidentiality.
• Support quality improvement initiatives related to scheduling workflows.
• Other duties as assigned.

Clinical Case Manager

Registered Nurse, Home Health Assessments

Registered Nurse, Home Health Assessments

Registered Nurse, Home Health Assessments

Registered Nurse, Home Health Assessments

Registered Nurse, Home Health Assessments

Sourcing Specialist, Registered Nurses – Temp

Part-Time RN, MDS Assessments

Field RN – MDS Assessments

Part-Time Field RN, MDS Assessments

Field RN – MDS Assessments

Part-Time Field RN – MDS Assessments

Part-Time Field RN, MDS Assessments

Part-Time Field RN – MDS Assessments

Scheduling Coordinator