HYBRID Non Clinical Registered Nurse - 260490

Position Type: Full-Time (35 Hours/Week)

Work Arrangement: Hybrid (Remote / Local Community or Office Visits as Needed)

Schedule: Monday – Friday, flexible scheduling between 8:00 AM – 8:00 PM

Department: Enrollment / Population HealthWhy You’ll Love This RoleAre you looking to transition away from the physical demands of bedside nursing while keeping the patient-centered connection you value most? This hybrid non-clinical nursing role blends clinical assessment, member advocacy, and education into a more predictable, balanced workflow. Here, you will help prospective members and their families navigate critical long-term care decisions, while building valuable expertise in population health, care management, and Medicaid/MLTC programs. It offers an ideal foundation for career growth into care management, utilization review, quality improvement, or leadership within the health plan space.

Role Overview: We are seeking an experienced Registered Nurse (RN) for a hybrid non-clinical position supporting the enrollment of individuals into our Managed Long-Term Care (MLTC) program. In this role, you will conduct comprehensive initial assessments, evaluate care needs, and guide prospective members and their caregivers through the program's service offerings. You will serve as an educator and advocate, ensuring that individuals entering the plan clearly understand available services, next steps, and care coordination processes.

Key Responsibilities: Comprehensive Clinical Assessments: Conduct initial clinical and functional assessments for prospective members, evaluating medical history, diagnoses, medications, cognitive status, functional limitations, and social support systems. Functional & Care Level Evaluation: Assess Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) to establish appropriate levels of care and program suitability. Chart Review & Information Gathering: Review available medical records and collaborate with prospective members, caregivers, and providers to obtain supplemental clinical data as needed. Member & Family Education: Explain program benefits, services, care management coordination, and expectations in a compassionate, accessible manner; address clinical and operational questions directly. Identify Care Barriers: Recognize potential challenges to enrollment, sustained engagement, or continuity of care early in the intake process. Timely Documentation: Accurately complete all assessment forms, notes, and intake documentation within established turnaround times using electronic health records (EHR).Cross-Functional Collaboration: Partner closely with internal enrollment, care management, clinical, and administrative teams to communicate clinical findings and facilitate seamless transitions. Compliance & Standards: Adhere strictly to state Medicaid, MLTC program regulations, organizational policies, and HIPAA guidelines.

License: Current, active, and unencumbered Registered Nurse (RN) license in the state of practice.

Education: Associate Degree in Nursing (ADN) or equivalent accredited nursing education. Clinical Experience: Minimum of 2 years of clinical nursing experience. Program Experience: Prior Managed Long-Term Care (MLTC) experience. Assessment Skills: Demonstrated strength in conducting comprehensive clinical assessments, interviewing patients/families, and evaluating functional status (ADLs/IADLs).Technical & Documentation Skills: Strong written and verbal communication, solid clinical documentation habits, and hands-on experience navigating electronic medical record (EMR/EHR) systems.