CNA Home Health Other
Fallon Health

CNA / Home Health Aide - Great Pay- $ 24.00 per hour - Worcester/Framingham - Per Diem

Fallon Health Framingham, MA
$20 - $24 / hour
Overview This is one of the better opportunities out there for Health Aides or CNAs and we will take great care of you! Why?.. + *$20/hr to start and exceeds state pay average! You can also make extra depending of the shifts you can work. + Mileage Reimbursement! + Respectful and Desirable Health Aide / CNA Work Setting! Predictable Hours! Safe and highly vaccinated work environment including the member population you care for Our Health Aides and staff love the familiarity and relationships establishes with our members You will likely find more autonomy and flexibility than you have in your current role Our model is low-volume and very member and quality care focused About us: Fallon Health is a company that cares. We prioritize our members--always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, we deliver equitable, high-quality coordinated care and are continually rated among the nation’s top health plans for member experience, service, and clinical quality. Fallon Health’s Summit ElderCare® is a Program of All-Inclusive Care for the Elderly–PACE for short. PACE, an alternative to nursing home care, is a program that helps people 55 and older continue living safely at home. At Fallon Health, we believe our individual differences, life experiences, knowledge, self-expression and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE— in the region. Summary: Provides personal care, light housekeeping and assistance with ADLs (Activities of Daily Living) as outlined in each SE participant’s plan of care in participant homes as well as at the PACE center; exercises independent judgement; reports any changes in participant status to the IDT; participates in carrying out infection control precautions and increased cleaning and disinfecting of the PACE center as assigned and in accordance with current CDC guidelines Responsibilities Under the supervision of the RN, assists with the Activities of Daily Living (ADL) needs of participants both at the PACE center and in participants’ homes (i.e., community, Assisted Living Facilities, Rest Homes, Supportive Housing programs, etc.) Contributes to the development of a care plan for participants through interaction with other members of the Interdisciplinary Team. Collaborates with members of the Interdisciplinary Team to assure appropriateness and continuity of care. Carries out non-skilled treatments including, but not limited to vital signs, transfers, toileting, bathing, dressing at the PACE Center and in the community. Assists the Supervisor, Recreational Activities and other activities staff with individual and group programs by helping to plan individual treatment programs, increasing participants’ motivation to participate, assisting participants to participate when needed, and assisting with evaluation of program effectiveness. Assists registered therapists and certified therapy assistants with treatments and participant-specific activities which are ordered for each participant and assigned by the registered therapist including, but not limited to, positioning, transfers, ambulation, and exercises. Maintains a clean and safe working and/or living environment in the PACE center and/or participants’ homes. Assists with meal and snack preparation, serving, feeding as needed, and clean-up. Uses safe techniques in all interactions with participants at the PACE Center and in participants’ homes. Provides accurate and timely documentation in the EMR and other systems as required by SE policies and procedures and/or as assigned by supervisor. Participates in carrying out schedule of daily cleaning and disinfecting of the PACE center in accordance with CDC guidelines for increased precautions Actively participates in distribution of work for health aides to ensure care needs of participants and site tasks are completed timely and appropriately including but not limited to community-based care and center-based tasks, as assigned Actively participates in regular team meetings for health aides at respective site Participates in carrying out infection control precautions and increased cleaning and disinfecting of the PACE center as assigned and in accordance with current CDC guidelines Performs all duties in accordance with FH and Summit ElderCare policies and procedures. Qualifications Education: Completion of an approved Home Health Aide or Certified Nursing Assistant Training Program is highly desirable, but we will accept equivalent work experience in lieu of certificate. Certification: Certification as a Home Health Aide or Nursing Assistant is desired. Reliable Transportation Required. Experience: One year of experience working with a frail and/or older adult population preferably in a PACE program. If under one year, must complete Summit Eldercare training program for health aides prior to working with participants independently. Must complete a standardized set of Summit Eldercare competencies for Health Aides on an annual basis. Pay Range Disclosure: In accordance with the Massachusetts Wage Transparency Act, the pay range for this position is $20.00 to $24.00 per hour , which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate’s experience, skills, and fit with the role’s responsibilities. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
CMA Other
Fallon Health

SE Office Coordinator-Springfield, MA

Fallon Health Springfield, MA
$21 - $23 / hour
Overview About us: Fallon Health is a company that cares. We prioritize our members--always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, we deliver equitable, high-quality coordinated care and are continually rated among the nation’s top health plans for member experience, service, and clinical quality. Fallon Health’s Summit ElderCare® is a Program of All-Inclusive Care for the Elderly–PACE for short. PACE, an alternative to nursing home care, is a program that helps people 55 and older continue living safely at home. At Fallon Health, we believe our individual differences, life experiences, knowledge, self-expression and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE— in the region. Brief Summary of purpose: The SE Office Coordinator has overall responsibility for all daily front office functions. Ability to direct all calls to the appropriate department and staff and obtain and convey messages. Ability to handle a multi-line phone system efficiently with compassion and calmness. Responsible for the maintenance of records of transportation for the members of the program and maintain a good relationship with our transportation vendor. Serves as the primary contact for all transportation concerns. Responsible for all daily incoming and outgoing mail, faxes and copying needed for all departments. Responsibilities Primary Job Responsbilities Greet participants and public with positive demeanor. Answer telephone calls; direct calls to appropriate staff; transcribe and convey messages Open and sort incoming mail Type general office correspondence; letters, memorandums, etc. Maintain and distribute faxes utilizing e-faxing Call and fax all transportation changes to vendor Maintain accurate arrival/departure time log Notify all needed departments of transportation changes and cancellations Log grievances and/or incidents into database for purpose of quality improvement Responsible for scheduling all outside medical appointments as well as intakes, obtaining medical records and scheduling transportation if necessary Maintaining the Electronic Health Record (EHR) utilizing NextGen ensuring that charts are current Entering authorizations using QNXT Scan all medical records from current and previous providers accurately and in a timely manner within the EHR Works collaboratively and at the direction of the Supervisor on work plan and priorities, using established procedures to assure timely completion of assigned work in conformance with established departmental policies and standards Qualifications Education High school graduate or equivalent License/Certifications Access to reliable transportation to perform work throughout the PACE center’s service area (30-mile radius) when needed. Willingness to occasionally assist other SE PACE centers either in person or remotely, as appropriate, when there is an opening or a gap in coverage. Experience 2 years of customer service, secretarial, or receptionist experience required (in a healthcare setting desirable) Proficient in standard office software (Word, Excel, Outlook, Power Point) is a must Excellent Customer service skills required Pay Range Disclosure: In accordance with the Massachusetts Wage Transparency Act, the pay range for this position is $21.00 to $23.00 per hour , which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate’s experience, skills, and fit with the role’s responsibilities. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
RN Other
Fallon Health

Senior Care Options Nurse Case Manager - Lawrence

Fallon Health Lawrence, MA
$95,000 - $100,000 / year
Overview The Nurse Case Manager will be covering and visiting members in North Chelmsford, Lawrence, Lynnfield, Medford, Medford, West Medford, Melrose, Stoneham, and Tewksbury. About us: Fallon Health is a company that cares. We prioritize our members—always—making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon Health delivers equitable, high-quality, coordinated care and is continually rated among the nation’s top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)— in the region. Learn more at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn. Brief summary of purpose: The Nurse Case Manager (NCM) is an integral part on an interdisciplinary team focused on care coordination, care management and improving access to and quality of care for Fallon members. NCM seeks to establish telephonic and/or face to face relationships with the member/caregiver(s) to better ensure ongoing service provision and care coordination, consistent with the member specific care plan developed by the NCM and Care Team. Responsibilities may include conducting in home face to face visits for member identified as needing face to face visit interaction and assessments with the goal to coordinate and facilitate services to meet member needs according to benefit tstructures and available community resources. The NCM may conduct assessments and may determine the number of hours’ members require for MassHealth programs such as the personal care attendant program, adult foster care, group adult foster care, and other programs per product benefits and guidelines. The NCM may utilize an ACD line to support department and incoming/outgoing calls with the goal of first call resolution with each interaction. Responsibilities Note: Job Responsibilities may vary depending upon the member’s Fallon Health Product Member Assessment, Education, and Advocacy Telephonically assesses and case manages a member panel May conduct in home face to face visits for onboarding new enrollees and reassessing members, utilizing a variety of interviewing techniques, including motivational interviewing, and employs culturally sensitive strategies to assess a Member’s clinical/functional status to identify ongoing special conditions and develops and implements an individualized,coordinated care plan, in collaboration with the member, the Clinical Integration team, and Primary Care Providers, Specialist and other community partners, to ensure a cost effective quality outcome Performs medication reconciliations Performs Care Transitions Assessments – per Program and product line processes Utilizing clinical judgment and nursing assessment skills, may complete NaviCare Program Assessment Tools and Minimum Data Set Home Care (MDS HC) Form when a member’s medical/functional status changes that warrants a change in rating category to ensure members are in the correct State defined rating category Maintains up to date knowledge of Program and product line benefits, Plan Evidence of Coverage details, and department policies and processes and follows policies and processes as outlined to be able to provide education to members and providers; performing a member advocacy and education role including but not limited to member rights Serves as an advocate for members to ensure they receive Fallon Health benefits as appropriate and if member needs are identified but not covered by Fallon Health, works with community agencies to facilitate access to programs such as community transportation, food programs, and other services available through senior centers and other external partners Follows department and regulatory standards to authorize and coordinate healthcare services ensuring timeliness in compliance with documented care plan goals and objectives Assesses the Member’s knowledge about the management of current disease processes and medication regimen, provides teaching to increase Member/caregiver knowledge, and works with the members to assist with learning how to self- manage his or her health needs, social needs or behavioral health needs Collaborates with appropriate team members to ensure health education/disease management information is provided as identified Collaborates with the interdisciplinary team in identifying and addressing high risk members Educate members on preventative screenings and other health care procedures such as vaccines, screenings according to established protocols and program processes such initiatives involving Key Metrics outreach Ensures members/PRAs participate in the development and approval of their care plans in conjunction with the interdisciplinary primary care team Strictly observes HIPAA regulations and the Fallon Health Policies regarding confidentiality of member information Supports Quality and Ad-Hoc campaigns Care Coordination and Collaboration Provides culturally appropriate care coordination, i.e. works with interpreters, provides communication approved documents in the appropriate language, and demonstrates culturally appropriate behavior when working with member, family, caregivers, and/or authorized representatives With member/authorized representative(s) collaboration develops member centered care plans by identifying member care needs while completing program assessments and working with the Navigator to ensure the member approves their care plan Manages NaviCare members in conjunction with the Navigator, Behavioral Health Case Manager, Aging Service Access Point Geriatric Support Service Coordinator, contracted Primary Care Providers and others involved/authorized in the member’s care Manages ACO members in conjunction with the Navigator, Social Care Managers, ACO Partners, Community Partners, Behavioral Health Partners and others involved/authorized in the member’s care Monitors progression of member goals and care plan goals, provides feedback and works collaboratively with care team members and work effectively in a team model approach to coordinate a continuum of care consistent with the Member’s health care goals and needs Works collaboratively with Fallon Health Pharmacist, referring members in need of medication review based upon Program process Develops and fosters relationships with members, family, caregivers, PRAs, vendors and providers to ensure good collaboration and coordination by streamlining the focus of the Member’s healthcare needs utilizing the most optimal treatment approach, promoting timely provision of care, enhancing quality of life, and promoting cost-effectiveness of care Actively participates in clinical rounds Provider Partnerships and Collaboration May attend in person care plan meetings with providers and office staff and may lead care plan review with providers and care team as applicable. Demonstrates positive customer service actions and takes responsibility to ensure member and provider requests and needs are met Regulatory Requirements – Actions and Oversight Completes Program Assessments, Notes, Screenings, and Care Plans in the Centralized Enrollee Record according to product regulatory requirements and Program policies and processes Knowledge of and compliance with HEDIS and Medicare 5 Star measure processes, performing member education, outreach, and actions in conjunction with the Navigator and other members of the Clinical Integration and Partner Teams Performs other responsibilities as assigned by the Manager/designee Supports department colleagues, covering and assuming changes in assignment as assigned by Manager/designee Qualifications Education: 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 Certification : Certification in Case Management strongly desired Other : Satisfactory Criminal Offender Record Information (CORI) results and reliable transportation Experience: • 1+ years of clinical experience as a Registered Nurse managing chronically ill members or experience in a coordinated care program required• Understanding of Hospitalization experiences and the impacts and needs after facility discharge required• Experience working face to face with members and providers preferred• Experience with telephonic interviewing skills and working with a diverse population, that may also be Non-English speaking, required• Home Health Care experience preferred• Effective case management and care coordination skills and the ability to assess a member’s activities of daily function and independent activities of daily function and the ability to develop and implement a care plan that meets the member’s need working in partnership with a care team preferred• Familiarity with NCQA case management requirements preferred Performance Requirements including but not limited to: • Excellent communication and interpersonal skills with members and providers via telephone and in person• Exceptional customer service skills and willingness to assist ensuring timely resolution• 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• Working with an interdisciplinary care team as a partner demonstrating respect and value for all roles and is a positive contributor within job role scope and duties• Willingness to learn insurance regulatory and accreditation requirements• Knowledgeable about software systems including but not limited to Microsoft Office Products – Excel, Outlook, and Word • Familiar with Excel spreadsheets to manage work and exposure and familiarity with pivot tables• Accurate and timely data entry• Effective case management and care coordination skills and the ability to assess a member’s activities of daily function and independent activities of daily function and the ability to develop and implement a care plan that meets the member’s need • Knowledge about community resources, levels of care, criteria for levels of care and the ability to appropriately develop and implement a care plan following regulatory guidelines and level of care criteria • Ability to effectively respond and adapt to changing business needs and be an innovative and creative problem solver 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, shifing priorities, ambiguity, and rapid change Demonstrates flexibility Written Communication Is able to write clearly and succinctly in a variety of communication settings and styles. Pay Range Disclosure: In accordance with the Massachusetts Wage Transparency Act, the pay range for this position is $95,000 - $100,000 per year, which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate’s experience, skills, and fit with the role’s responsibilities. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. #P01
CMA Other
Fallon Health

SE Primary Nurse - Springfield, MA

Fallon Health Springfield, MA
$92,000 - $93,000 / year
Overview About us: Fallon Health is a company that cares. We prioritize our members--always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, we deliver equitable, high-quality coordinated care and are continually rated among the nation’s top health plans for member experience, service, and clinical quality. Fallon Health’s Summit ElderCare® is a Program of All-Inclusive Care for the Elderly–PACE for short. PACE, an alternative to nursing home care, is a program that helps people 55 and older continue living safely at home. At Fallon Health, we believe our individual differences, life experiences, knowledge, self-expression and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE— in the region. Brief Summary of purpose Responsible for the effective management and delivery of direct nursing care to PACE participants in any setting utilizing nursing process and adhering to standards of nursing practice. Responsibilities Primary Job Responsibilities Primary nurse not only has the responsibility for the participant, but the authority to advocate for the best care for the participant unique to their situation. Fostering a relationship with the caregiver and participant. Primary Nurse will take on a Leadership Role. Effectively communicate with the healthcare team. Assigns tasks and duties to the healthcare team; ensure the tasks are completed; responsible for their panel. Develops an individualized plan of care. Accountability for assessments, communicating needs and coordinating the care team. Primary nurse develops the plan of care Reviews and implements Provider’s orders. Conducts nursing assessments according to policy guidelines including physical, psychosocial, behavioral, and MDS-HC as indicated. Involves participants and significant other(s) based on needs and abilities. Delivers care to participants in any setting, including skilled services, based on individualized needs and according to age-appropriate nursing standards. Provides for cultural and diverse needs of participants when providing care. Monitors and evaluates therapeutic interventions. Delegates and or accepts participants’ care responsibilities to other members of the health care team, when appropriate. Identifies emergency situations and initiates appropriate nursing orders/interventions. Meets the needs of participants in a timely manner. Participates in the interdisciplinary team (IDT) process and collaborates with IDT members to meet the needs of participants. Consistently documents all aspects of participant care, including significant changes in health status, monthly nurses’ notes and health care teaching in the medical record. Participates in training and orientation of new nursing staff as assigned. Assists in the delivery of other nursing services as assigned. Participates in the nursing “on-call” rotation as assigned. Initiates and completes falls, infection, grievance and incident reports Participates in CMS calls when deemed necessary. Active participant in the site specific committees. Participates in the post IDT huddle and any other additional meetings Any additional tasks deemed necessary by the Clinical Nurse Manager and or Site Director. Assumes the role of the home care nurse, floor or triage nurse per the direction of the Clinical Nurse Manager or Site Director as appropriate. Performs all duties in accordance with FCHP and Summit ElderCare policies and procedures. Functions independently to administer medications and treatments as ordered by the provider. Functions independently in the primary nurse role. Independent in performing a nursing assessment and executing the plan of care in all settings the participant maybe in. Medication administration Performing bladder scans, EKG, Point of Care, and glucometer testing Qualifications Education: Graduate of an accredited school of nursing License/Certifications: Current license as an RN in the state of Massachusetts CPR and Alzheimer’s certification, or willingness to be certified within 60 days of hire, is essential. Access to reliable transportation to perform work throughout the PACE center’s service area (30-mile radius) when needed. Willingness to occasionally assist other SE PACE centers either in person or remotely, as appropriate, when there is an opening or a gap in coverage Experience: At least two years of recent experience in the direct care of adults or chronically disabled persons with at least one year caring for a frail or elderly population. Ambulatory care or home care experience helpful. Ability to use an electronic medical record. Other: Reliable Transportation Required Pay Range Disclosure: In accordance with the Massachusetts Wage Transparency Act, the pay range for this position is $92,000 - $93,000 per year, which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate’s experience, skills, and fit with the role’s responsibilities. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
RN Other
Fallon Health

Medicare/Community Care Nurse Case Manager - Hybrid Remote

Fallon Health Worcester, MA
$88,000 - $95,000 / year
Overview About us: Fallon Health is a company that cares. We prioritize our members—always—making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon Health delivers equitable, high-quality, coordinated care and is continually rated among the nation’s top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)— in the region. Learn more at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn. Summary of purpose: The Nurse Case Manager (NCM) is an integral part of an interdisciplinary team focused on care coordination, care management and improving access to and quality of care for Fallon members, specifically for Medicare and Community Care membership. The NCM seeks to establish telephonic relationships with the member/caregiver(s) to better ensure ongoing service provision and care coordination, consistent with member specific needs and quality metrics developed by the NCM and support team. Responsibilities may include regular telephonic assessments, care planning and identifying member specific priorities, and assessments with the goal to coordinate and facilitate services to meet member needs according to benefit structures and available community resources. The NCM must be familiar with quality metrics including STARS and HEDIS as well as guiding factors within the NCQA standards. Emphasis is placed on complex case management, reducing readmission rates and ensuring that members’ needs are met at time of transition from ER/inpatient hospitalization to home. The NCM must understand the effect that social determinants of health have on health outcomes, identify barriers to remaining safe in the community and align members with community supports to meet SDOH needs. The NCM is also required to have an understanding of the benefit structure for both Medicare and Community Care. Responsibilities Primary Job Responsibiities Note: Job Responsibilities may vary depending upon the member’s Fallon Health Product Member Assessment, Education, and Advocacy Telephonically assesses and manages a member panel Conducts cold calls to members identified as having a potential need for case management Regular assessment of members’ needs, utilizing a variety of interviewing techniques, including motivational interviewing, and employs culturally sensitive strategies to assess a member’s clinical/functional status to identify ongoing special conditions and develops and implements an individualized, coordinated care plan, in collaboration with the member, the support team, community resources and providers Performs medication reconciliations Performs Care Transitions Assessments – per program and product line processes Assesses for risk for readmission utilizing tools like PointClickCare Participates in multidisciplinary rounds Ensure members preventive health metrics are complete to close HEDIS gaps in care Creates complex care plans and assessment in accordance with NCQA standards Maintains up to date knowledge of product line benefits, Plan Evidence of Coverage details, and department policies and processes and follows policies and processes as outlined to be able to provide education to members and providers; performing a member advocacy and education role including but not limited to member rights for both Medicare and Community Care Serves as an advocate for members to ensure they receive Fallon Health benefits as appropriate and if member needs are identified but not covered by Fallon Health, works with community agencies to facilitate access to programs such as community transportation, food programs, and other services available through senior centers and other external partners Follows department and regulatory standards to authorize and coordinate healthcare services ensuring timeliness in compliance with documented care plan goals and objectives Assesses the member’s knowledge about the management of current disease processes and medication regimen, provides teaching to increase member/caregiver knowledge, and works with the members to assist with learning how to self-manage his or her health needs, social needs or behavioral health needs Collaborates with appropriate team members to ensure health education/disease management information is provided as identified Identifies and refers members to other Fallon Health products as appropriate Must maintain working knowledge of all products offered at Fallon Health, including but not limited to NaviCare, ACO and Summit Collaborates with the interdisciplinary team in identifying and addressing high risk members Educate members on preventative screenings and other health care procedures such as vaccines, screenings according to established protocols and program processes such initiatives involving Key Metrics outreach Identifies SDOC needs and appropriately collaborates with community partners to ensure needs are being met Manages members who are at risk for Medication non-compliance by working closely with the Fallon pharmacy team and outreaching members as needed Strictly observes HIPAA regulations and the Fallon Health Policies regarding confidentiality of member information Supports Quality and Ad-Hoc campaigns Care Coordination and Collaboration Provides culturally appropriate care coordination, i.e. works with interpreters, provides communication approved documents in the appropriate language, and demonstrates culturally appropriate behavior when working with member, family, caregivers, and/or authorized representatives With member/authorized representative(s) collaboration develops member centered care plans by identifying member care needs Manages members in conjunction with the Navigator, Behavioral Health Case Manager, and community supports as appropriate Monitors progression of member goals and care plan goals, provides feedback and works collaboratively with care team members and work effectively in a team model approach to coordinate a continuum of care consistent with the Member’s health care goals and needs Works collaboratively with Fallon Health Pharmacy team, referring members in need of medication review based upon member need Develops and fosters relationships with members, family, caregivers, PRAs, vendors and providers to ensure good collaboration and coordination by streamlining the focus of the member’s healthcare needs utilizing the most optimal treatment approach, promoting timely provision of care, enhancing quality of life, and promoting cost-effectiveness of care Acts as an advocate for members ensuring that their medical needs are being met in an effective manner Identifies social determinate of health needs and works cohesively with the care team and external supports to help close these disparities Actively participates in clinical rounds Provider Partnerships and Collaboration Ensures providers are updated with any critical health issues Advocates for member needs with providers as needed Educates members on quality gaps in care as needed Demonstrates positive customer service actions and takes responsibility to ensure member and provider requests and needs are met Familiarizes oneself with multiple provider and facility electronic medical records to obtain and review member records Regulatory Requirements – Actions and Oversight Completes Program Assessments, Notes, Screenings, and Care Plans in the Centralized Enrollee Record according to product regulatory requirements and Program policies and processes Knowledge of and compliance with HEDIS and Medicare 5 Star measure processes, performing member education, outreach, and actions in conjunction with the Navigator and other members of the Clinical Integration and Partner Teams Familiarizes oneself with CAHPS questions to better ready members for survey Is a subject matter expert in Complex Case Management to meet NCQA standards Performs other responsibilities as assigned by the Manager/designee Supports department colleagues, covering and assuming changes in assignment as assigned by Manager/designee Qualifications Education: Graduate from an accredited school of nursing mandatory and a Bachelors (or advanced) degree in nursing or a health care related field preferred. License/Certifications License: Active, unrestricted license as a Registered Nurse in Massachusetts Certification : Certification in Case Management strongly desired Other: Satisfactory Criminal Offender Record Information (CORI) results and reliable transportation Experience: 1+ years of clinical experience as a Registered Nurse managing chronically ill members or experience in a coordinated care program required Understanding of hospitalization experiences and the impacts and needs after facility discharge required Experience working face to face with members and providers preferred Experience with telephonic interviewing skills and working with a diverse population, that may also be non-English speaking, required Home Health Care experience preferred Effective case management and care coordination skills and the ability to assess a member’s activities of daily function and independent activities of daily function and the ability to develop and implement a care plan that meets the member’s need working in partnership with a care team preferred Familiarity with NCQA, CAHPS and Stars/HEDIS metrics preferred Performance Requirements including but not limited to: Excellent communication and interpersonal skills with members and providers via telephone and in person Exceptional customer service skills and willingness to assist ensuring timely resolution 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 Working with an interdisciplinary care team as a partner demonstrating respect and value for all roles and is a positive contributor within job role scope and duties Willingness to learn insurance regulatory and accreditation requirements Knowledgeable about software systems including but not limited to Microsoft Office Products – Excel, Outlook, and Word Familiar with Excel spreadsheets to manage work and exposure and familiarity with pivot tables Accurate and timely data entry Effective case management and care coordination skills and the ability to assess a member’s activities of daily function and independent activities of daily function and the ability to develop and implement a care plan that meets the member’s need Knowledge about community resources, levels of care, criteria for levels of care and the ability to appropriately develop and implement a care plan following regulatory guidelines and level of care criteria Ability to effectively respond and adapt to changing business needs and be an innovative and creative problem solver 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, look 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 Able to write clearly and succinctly in a variety of communication settings and styles Oral Communication Able to effectively communicate with members, providers and community supports Effective interviewing skills to draw information from members to create cohesive and effective care plans Pay Range Disclosure: In accordance with the Massachusetts Wage Transparency Act, the pay range for this position is $88,000 - $95,000 per year, which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate’s experience, skills, and fit with the role’s responsibilities. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. #P02
CMA Manager/Supervisor Other
Fallon Health

Manager, Social Work- Growing Adult PACE program - Webster MA

Fallon Health Webster, MA
$100,000 - $104,000 / year
Overview About us: Fallon Health is a company that cares. We prioritize our members--always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, we deliver equitable, high-quality coordinated care and are continually rated among the nation’s top health plans for member experience, service, and clinical quality. Fallon Health’s Summit ElderCare® is a Program of All-Inclusive Care for the Elderly–PACE for short. PACE, an alternative to nursing home care, is a program that helps people 55 and older continue living safely at home. At Fallon Health, we believe our individual differences, life experiences, knowledge, self-expression and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE— in the region. Brief summary of purpose: Functions as a member of the PACE Interdisciplinary Team and provides social work services, support and counseling to participants, families and other caregivers. Supervises and directs the Social Work Department in accordance with accepted social work practice. Collaborates with IDT and SE management team to ensure utilization and MLR targets are met. Responsibilities Primary job responsibilities: Provides clinical services to participants and families in the form of psychosocial assessment and treatment. Provides on-going case management for participants as needs and status changes. Identifies and coordinates resources for participants and their families. Refers participants and their families to appropriate community/government agencies. Acts as advocate and liaison to obtain needed services. Participates in care planning, family meetings, enrollment/disenrollment, and reassessments of SE participants to meet regulatory requirements. Assures that participants rights are reviewed during the intake process. Participates in meetings, committees, in-services, orientation etc. as required. Participates in policy/procedure and job description development for Social Work Department. Establishes and maintains effective collegial relationships with interdisciplinary team members. Develops collaborative relationships with other health and human services agencies and community providers. Consults with and advises staff members of the relationship of social, emotional, and cultural factors of health and medical care. Participates in Quality Improvement initiatives. Encourages and facilitates subordinates’ ability to participate. Directly supervises and provides clinical supervision to other social workers. Interviews, hires, and trains employees. Conducts regular touchpoint meetings, completes performance appraisals, ensures employee competencies, and addresses employee relations issues immediately and directly. Keeps Site Director informed of all employee relations issues and other issues as necessary. Keeps current on changing rules and regulations regarding Medicare/Medicaid eligibilities. Communicates changes in regulations affecting the PACE program to Social Workers. Qualifications Education : Masters in Social Work License: Valid and unrestricted license to practice social work from the Board of Registration of Social Work of the Commonwealth of Massachusetts (i.e., LCSW or LICSW) Driving your personal motor vehicle is an essential job function of this position and the following requirements apply: Must possess a valid drivers’ license Must attest to no disqualifiers per Driver Safety Policy Must possess and provide proof of minimal state required auto insurance Must have reliable transportation Experience: At least five years of experience in a social work capacity, preferably in a medical setting, with a minimum of 2 years of experience working with a frail or elderly population. At least 2 years of supervisory experience preferred. Pay Range Disclosure: In accordance with the Massachusetts Wage Transparency Act, the pay for this position is$ 100,000-$ 104,000 annually which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate’s experience, skills, and fit with the role’s responsibilities. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. #P01
Home Health Aide Home Health Other
Fallon Health

Home Health Aide-Dartmouth

Fallon Health Dartmouth, MA
$20 / hour
Overview This is one of the better opportunities out there for Health Aides or CNAs and we will take great care of you! Why?.. + Great benefits! Full-time benefits offering! Health Insurance offerings! Paid Time Off! 12 Holidays! 401K Savings Plan! Tuition Assistance! Vision Care, Life Insurance and more!! + *$20/hr to start and exceeds state pay average! You can also make extra depending of the shifts you can work. + Mileage Reimbursement! + Respectful and Desirable Health Aide / CNA Work Setting! Predictable Hours! Safe and highly vaccinated work environment including the member population you care for Our Health Aides and staff love the familiarity and relationships establishes with our members You will likely find more autonomy and flexibility than you have in your current role Our model is low-volume and very member and quality care focused About us: Fallon Health is a company that cares. We prioritize our members--always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, we deliver equitable, high-quality coordinated care and are continually rated among the nation’s top health plans for member experience, service, and clinical quality. Fallon Health’s Summit ElderCare® is a Program of All-Inclusive Care for the Elderly–PACE for short. PACE, an alternative to nursing home care, is a program that helps people 55 and older continue living safely at home. At Fallon Health, we believe our individual differences, life experiences, knowledge, self-expression and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE— in the region. Summary: Provides personal care, light housekeeping and assistance with ADLs (Activities of Daily Living) as outlined in each SE participant’s plan of care in participant homes as well as at the PACE center; exercises independent judgement; reports any changes in participant status to the IDT; participates in carrying out infection control precautions and increased cleaning and disinfecting of the PACE center as assigned and in accordance with current CDC guidelines Responsibilities Under the supervision of the RN, assists with the Activities of Daily Living (ADL) needs of participants both at the PACE center and in participants’ homes (i.e., community, Assisted Living Facilities, Rest Homes, Supportive Housing programs, etc.) Contributes to the development of a care plan for participants through interaction with other members of the Interdisciplinary Team. Collaborates with members of the Interdisciplinary Team to assure appropriateness and continuity of care. Carries out non-skilled treatments including, but not limited to vital signs, transfers, toileting, bathing, dressing at the PACE Center and in the community. Assists the Supervisor, Recreational Activities and other activities staff with individual and group programs by helping to plan individual treatment programs, increasing participants’ motivation to participate, assisting participants to participate when needed, and assisting with evaluation of program effectiveness. Assists registered therapists and certified therapy assistants with treatments and participant-specific activities which are ordered for each participant and assigned by the registered therapist including, but not limited to, positioning, transfers, ambulation, and exercises. Maintains a clean and safe working and/or living environment in the PACE center and/or participants’ homes. Assists with meal and snack preparation, serving, feeding as needed, and clean-up. Uses safe techniques in all interactions with participants at the PACE Center and in participants’ homes. Provides accurate and timely documentation in the EMR and other systems as required by SE policies and procedures and/or as assigned by supervisor. Participates in carrying out schedule of daily cleaning and disinfecting of the PACE center in accordance with CDC guidelines for increased precautions Actively participates in distribution of work for health aides to ensure care needs of participants and site tasks are completed timely and appropriately including but not limited to community-based care and center-based tasks, as assigned Actively participates in regular team meetings for health aides at respective site Participates in carrying out infection control precautions and increased cleaning and disinfecting of the PACE center as assigned and in accordance with current CDC guidelines Performs all duties in accordance with FH and Summit ElderCare policies and procedures. Qualifications Education: Completion of an approved Home Health Aide or Certified Nursing Assistant Training Program is highly desirable, but we will accept equivalent work experience in lieu of certificate. Certification: Certification as a Home Health Aide or Nursing Assistant is desired. Reliable Transportation Required. Experience: One year of experience working with a frail and/or older adult population, preferably in a PACE program. If under one year, must complete Summit Eldercare training program for health aides prior to working with participants independently. Must complete a standardized set of Summit Eldercare competencies for Health Aides on an annual basis. Pay Range Disclosure: In accordance with the Massachusetts Wage Transparency Act, the pay for this position is $20.00 which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate’s experience, skills, and fit with the role’s responsibilities. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
CMA Other
Fallon Health

SE Primary Nurse - Webster, MA

Fallon Health Webster, MA
$92,000 - $93,000 / year
Overview About us: Fallon Health is a company that cares. We prioritize our members--always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, we deliver equitable, high-quality coordinated care and are continually rated among the nation’s top health plans for member experience, service, and clinical quality. Fallon Health’s Summit ElderCare® is a Program of All-Inclusive Care for the Elderly–PACE for short. PACE, an alternative to nursing home care, is a program that helps people 55 and older continue living safely at home. At Fallon Health, we believe our individual differences, life experiences, knowledge, self-expression and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE— in the region. Brief Summary of purpose Responsible for the effective management and delivery of direct nursing care to PACE participants in any setting utilizing nursing process and adhering to standards of nursing practice. Responsibilities Primary Job Responsibilities Primary nurse not only has the responsibility for the participant, but the authority to advocate for the best care for the participant unique to their situation. Fostering a relationship with the caregiver and participant. Primary Nurse will take on a Leadership Role. Effectively communicate with the healthcare team. Assigns tasks and duties to the healthcare team; ensure the tasks are completed; responsible for their panel. Develops an individualized plan of care. Accountability for assessments, communicating needs and coordinating the care team. Primary nurse develops the plan of care Reviews and implements Provider’s orders. Conducts nursing assessments according to policy guidelines including physical, psychosocial, behavioral, and MDS-HC as indicated. Involves participants and significant other(s) based on needs and abilities. Delivers care to participants in any setting, including skilled services, based on individualized needs and according to age-appropriate nursing standards. Provides for cultural and diverse needs of participants when providing care. Monitors and evaluates therapeutic interventions. Delegates and or accepts participants’ care responsibilities to other members of the health care team, when appropriate. Identifies emergency situations and initiates appropriate nursing orders/interventions. Meets the needs of participants in a timely manner. Participates in the interdisciplinary team (IDT) process and collaborates with IDT members to meet the needs of participants. Consistently documents all aspects of participant care, including significant changes in health status, monthly nurses’ notes and health care teaching in the medical record. Participates in training and orientation of new nursing staff as assigned. Assists in the delivery of other nursing services as assigned. Participates in the nursing “on-call” rotation as assigned. Initiates and completes falls, infection, grievance and incident reports Participates in CMS calls when deemed necessary. Active participant in the site specific committees. Participates in the post IDT huddle and any other additional meetings Any additional tasks deemed necessary by the Clinical Nurse Manager and or Site Director. Assumes the role of the home care nurse, floor or triage nurse per the direction of the Clinical Nurse Manager or Site Director as appropriate. Performs all duties in accordance with FCHP and Summit ElderCare policies and procedures. Functions independently to administer medications and treatments as ordered by the provider. Functions independently in the primary nurse role. Independent in performing a nursing assessment and executing the plan of care in all settings the participant maybe in. Medication administration Performing bladder scans, EKG, Point of Care, and glucometer testing Qualifications Education: Graduate of an accredited school of nursing License/Certifications: Current license as an RN in the state of Massachusetts CPR and Alzheimer’s certification, or willingness to be certified within 60 days of hire, is essential. Access to reliable transportation to perform work throughout the PACE center’s service area (30-mile radius) when needed. Willingness to occasionally assist other SE PACE centers either in person or remotely, as appropriate, when there is an opening or a gap in coverage Experience: At least two years of recent experience in the direct care of adults or chronically disabled persons with at least one year caring for a frail or elderly population. Ambulatory care or home care experience helpful. Ability to use an electronic medical record. Other: Reliable Transportation Required Pay Range Disclosure: In accordance with the Massachusetts Wage Transparency Act, the pay range for this position is $92,000 - $93,000 per year, which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate’s experience, skills, and fit with the role’s responsibilities. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
CMA Other
Fallon Health

Physician MD - Dartmouth, MA

Fallon Health Dartmouth, MA
$275,000 - $300,000 / year
Overview Join a Mission-Driven Team at Fallon Health Summit ElderCare! Locations: Worcester, Leominster, Lowell, Springfield, Webster, Dartmouth - come take a tour and meet the team! Position: Primary Care Physician – PACE Program Salary Range: $275,000–$300,000/year, based on skills and experience. At Fallon Health, we don’t just offer jobs—we offer purpose. As part of our Summit ElderCare PACE program , you’ll be at the forefront of a growing, innovative model of care that helps older adults live safely and independently at home. If you’re passionate about quality over quantity , enjoy working in a collaborative interdisciplinary team , and want to make a real difference in the lives of frail elders, this is the opportunity for you. Work-Life Balance: Monday–Friday, 8-hour days with a flexible schedule , and an optional administrative day with no direct patient care . Patient-centered Care: See an average of 4 patients per day, with an average panel of 65, allowing time for more meaningful care. Team-based Culture: Work alongside a dedicated interdisciplinary team of geriatric care professionals Mentorship & Growth: Benefit from strong peer mentorship and leadership support Mission-driven Work: Help frail elders avoid nursing home placement and live with dignity in the community "PACE is the future of elder care—and Fallon Health is leading the way. If you’re looking for a career where your time, expertise, and compassion truly matter, Summit ElderCare is the place to be." About us: Fallon Health’s Summit ElderCare® is a Program of All-Inclusive Care for the Elderly–PACE for short. PACE, an alternative to nursing home care, is a program that helps people 55 and older continue living safely at home. At Fallon Health, we believe our individual differences, life experiences, knowledge, self-expression and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status and other characteristics that make people unique. Overview: The team uses a collaborative approach to care planning and is called the Interdisciplinary Team (IDT). The IDT is comprised of Providers (MD/DO and NP/PA), Nurses, Social Workers, Physical and Occupational Therapists, Dieticians, Health Aides, R Brief summary of purpose: The primary role is to provide high quality, cost effective medical care to program participants in accordance with the program mission and participant goals. Responsibilities P rimary Job Responsibilities (include duties that represent 5% or more of employee's time) Support the intake and enrollment process by meeting with participants and caregivers to represent the program and conduct initial assessments. Conduct biannual participant assessments. Assist with the development and maintenance of participant care plans. Participate in the interdisciplinary team (IDT) process. Provide routine, preventive and urgent care to participants. Promote strong colloborative relationships between participants, their caregivers and other PACE staff. Provide and arrange for specialty care consultations in support of participant care plans. Incorporate and coordinate specialist reports and recommendations into the medical record, assessments and care planning. Complete all required documentation in the participant chart and other forms as directed. Participate in after hours on call arrangements as determined by the PACE Medical Director. Provide care and assessments of participants in the most appropriate setting including the PACE clinic, inpatient facilites or participants’ homes. Participate in committees and work teams as requested by the Medical Director. Work in partnership with the PACE transitional care coordinator to support achievement of quality and utilization goals. Develop effective collaborative relationships with community physicians and other providers. Perform participant chart audits as requested by the PACE Medical Director. Document complete diagnostic and procedure codes in the participant chart and encounter forms to support care plans and accurate revenue collection. Conduct community presentations or represent Summit ElderCare at external functions or meetings upon request of the Medical Director or Executive Director. Pursue professional growth through continuing education that, at the minimum, meets the Massachusetts Board of Registration requirements for license renewal. Assist with education of PACE staff upon request. Perform other duties as needed. Qualifications Education: Medical degree, Geriatric specialty strongly desired License/Certifications: A Doctor of Medicine or osteopathy legally authorized to practice medicine or surgery in the Commonwealth of Massachusetts. Current DEA certificate. Board certification Internal Medicine, Geriatrics or Family Practice preferred. Driving your personal motor vehicle is an essential job function of this position and the following requirements apply: Must possess a valid drivers’ license Must attest to no disqualifiers per Driver Safety Policy Must possess and provide proof of minimal state required auto insurance Must have reliable transportation Experience: At least 1 year working with a frail or elderly population. Strong clinical assessment and communication skills Ability to function effectively with an interdisciplinary team (IDT) approach. Pay Range Disclosure: In accordance with the Massachusetts Wage Transparency Act, the pay range for this position is $275,000 to $300,000 per year , which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate’s experience, skills, and fit with the role’s responsibilities. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. #P01
CMA Other
Fallon Health

Physician - SNF-ist - PACE Program - Worcester MA - flexible Schedule

Fallon Health Worcester, MA
$285,000 - $310,000 / year
Overview Join a Mission-Driven Team at Fallon Health Summit ElderCare! Position: SNFist (Skilled Nursing Facilityist) – PACE Program in WORCESTER, MA Salary Range: $285,000–$310,000/year, based on skills and experience. At Fallon Health, we don’t just offer jobs—we offer purpose. As part of our Summit ElderCare PACE program , you’ll be at the forefront of a growing, innovative model of care that helps older adults live safely and independently at home. If you’re passionate about quality over quantity , enjoy working in a collaborative interdisciplinary team , and want to make a real difference in the lives of frail elders, this is the opportunity for you. Work-Life Balance: Monday–Friday, 8-hour days with a flexible schedule , and an optional administrative day with no direct patient care . Patient-centered Care: See an average of 5 -6 patients per day Team-based Culture: Work alongside a dedicated interdisciplinary team of geriatric care professionals Mentorship & Growth: Benefit from strong peer mentorship and leadership support Mission-driven Work: Help frail elders avoid nursing home placement and live with dignity in the community "PACE is the future of elder care—and Fallon Health is leading the way. If you’re looking for a career where your time, expertise, and compassion truly matter, Summit ElderCare is the place to be." About us: Fallon Health’s Summit ElderCare® is a Program of All-Inclusive Care for the Elderly–PACE for short. PACE, an alternative to nursing home care, is a program that helps people 55 and older continue living safely at home. At Fallon Health, we believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities enable us to serve our members better. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics that make people unique. The Summit Eldercare skilled nursing facility physician is responsible for providing high-quality, participant-centered care to patients in skilled nursing facilities (SNFs). He/she will manage medically complex, post-acute and long-term care participants residing in Skilled nursing facilities. He/she will be responsible for initial and ongoing care at the assigned SNFs, optimizing participants’ health outcomes, in coordination with the SNF and Summit Eldercare Interdisciplinary team. Responsibilities Clinical care and oversight Review and cosign (when required) interdisciplinary documentation to ensure accuracy and regulatory alignment. Perform duties including, but not limited, to admission H&P, regulatory required physician visits, medications and treatment plans review, signatures on all orders and progress notes. Manage and coordinate treatment for participants with multiple chronic medical problems, acute/arising conditions, and complex medication regimens Lead and oversee all transitions, including hospital to SNF, ensuring timely and effective care Conduct daily or scheduled rounds in assigned skilled nursing facilities (SNFs) Collaborate closely with the SNF staff i.e. nursing staff, Director of nursing, rehab team, etc. Coordinate closely with the Summit Eldercare interdisciplinary team members Participate in daily SE IDT meetings and communications as needed to ensure effective, appropriate, and coordinated care Communicate effectively with participants, caregivers, facility staff and SE IDT members regarding patient goals, treatment plans and care transitions Build and sustain trusted relationships with SNF medical directors, Directors of Nursing, and key SNF clinical leaders to enhance care consistency and collaboration between SNFs and Summit Eldercare Maintain a regular, visible presence in each assigned SNF, promoting physician accessibility and adherence to PACE principles Partner with hospitalist, SE primary care provider and other team members, to support smooth transitions of care and reduce hospital admissions and readmissions Collaborate with SE team in meeting related utilization metric and MLR goals Regulatory compliance Ensure compliance with all CMS physician services requirements for SNFs, including required visit frequency, supervision requirements, medical oversight, and documentation standards When applicable, supervise advanced practitioners following state law and CMS regulations Document all physician visits and orders in compliance with SNF EMR standards and PACE documentation requirements. Participate in grievances reviews, when applicable, in collaboration with the SE team Review and co‑sign (when required) interdisciplinary documentation to ensure accuracy and regulatory alignment. Qualifications Education: Medical degree (MD or DO) from an accredited school of medicine License/ Certifications: MD or DO licensed in Massachusetts Board Certification in Internal Medicine, Family Practice, or Geriatrics (preferred) DEA certification 1+ year experience with frail or elderly populations Passion for team-based, patient-centered care Experience: 2-3 years’ experience in post-acute care, long-term care or geriatric settings Strong clinical skills in managing complex, frail patients with multiple chronic medical problems, preferably in a skilled nursing facility setting Knowledge in Skilled Nursing Facility (SNF) regulations and standards of care preferred Excellent communication and interpersonal skills Demonstrated ability to work effectively in an interdisciplinary team model, PACE model of care preferred Proficiency in using electronic medical records (EMR) Pay Range Disclosure: In accordance with the Massachusetts Wage Transparency Act, the pay range for this position is $285,000 to $310,000 per year , which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate’s experience, skills, and fit with the role’s responsibilities. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. #P01
Home Health Aide Home Health Other
Fallon Health

Home Health Aide-Springfield - Part time - M- F / 2-4 PM, 2-6 Thursday - $20.00 per hour

Fallon Health Springfield, MA
$20 / hour
Overview This is one of the better opportunities out there for Health Aides or CNAs and we will take great care of you! Why?.. + Great benefits! Full-time benefits offering! Health Insurance offerings! Paid Time Off! 12 Holidays! 401K Savings Plan! Tuition Assistance! Vision Care, Life Insurance and more!! + *$20/hr to start and exceeds state pay average! You can also make extra depending of the shifts you can work. + Mileage Reimbursement! + Respectful and Desirable Health Aide / CNA Work Setting! Predictable Hours! Safe and highly vaccinated work environment including the member population you care for Our Health Aides and staff love the familiarity and relationships establishes with our members You will likely find more autonomy and flexibility than you have in your current role Our model is low-volume and very member and quality care focused About us: Fallon Health is a company that cares. We prioritize our members--always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, we deliver equitable, high-quality coordinated care and are continually rated among the nation’s top health plans for member experience, service, and clinical quality. Fallon Health’s Summit ElderCare® is a Program of All-Inclusive Care for the Elderly–PACE for short. PACE, an alternative to nursing home care, is a program that helps people 55 and older continue living safely at home. At Fallon Health, we believe our individual differences, life experiences, knowledge, self-expression and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE— in the region. Summary: Provides personal care, light housekeeping and assistance with ADLs (Activities of Daily Living) as outlined in each SE participant’s plan of care in participant homes as well as at the PACE center; exercises independent judgement; reports any changes in participant status to the IDT; participates in carrying out infection control precautions and increased cleaning and disinfecting of the PACE center as assigned and in accordance with current CDC guidelines Responsibilities Under the supervision of the RN, assists with the Activities of Daily Living (ADL) needs of participants both at the PACE center and in participants’ homes (i.e., community, Assisted Living Facilities, Rest Homes, Supportive Housing programs, etc.) Contributes to the development of a care plan for participants through interaction with other members of the Interdisciplinary Team. Collaborates with members of the Interdisciplinary Team to assure appropriateness and continuity of care. Carries out non-skilled treatments including, but not limited to vital signs, transfers, toileting, bathing, dressing at the PACE Center and in the community. Assists the Supervisor, Recreational Activities and other activities staff with individual and group programs by helping to plan individual treatment programs, increasing participants’ motivation to participate, assisting participants to participate when needed, and assisting with evaluation of program effectiveness. Assists registered therapists and certified therapy assistants with treatments and participant-specific activities which are ordered for each participant and assigned by the registered therapist including, but not limited to, positioning, transfers, ambulation, and exercises. Maintains a clean and safe working and/or living environment in the PACE center and/or participants’ homes. Assists with meal and snack preparation, serving, feeding as needed, and clean-up. Uses safe techniques in all interactions with participants at the PACE Center and in participants’ homes. Provides accurate and timely documentation in the EMR and other systems as required by SE policies and procedures and/or as assigned by supervisor. Participates in carrying out schedule of daily cleaning and disinfecting of the PACE center in accordance with CDC guidelines for increased precautions Actively participates in distribution of work for health aides to ensure care needs of participants and site tasks are completed timely and appropriately including but not limited to community-based care and center-based tasks, as assigned Actively participates in regular team meetings for health aides at respective site Participates in carrying out infection control precautions and increased cleaning and disinfecting of the PACE center as assigned and in accordance with current CDC guidelines Performs all duties in accordance with FH and Summit ElderCare policies and procedures. Qualifications Education: Completion of an approved Home Health Aide or Certified Nursing Assistant Training Program is highly desirable, but we will accept equivalent work experience in lieu of certificate. Certification: Certification as a Home Health Aide or Nursing Assistant is desired. Reliable Transportation Required. Experience: One year of experience working with a frail and/or older adult population, preferably in a PACE program. If under one year, must complete Summit Eldercare training program for health aides prior to working with participants independently. Must complete a standardized set of Summit Eldercare competencies for Health Aides on an annual basis. Pay Range Disclosure: In accordance with the Massachusetts Wage Transparency Act, the pay for this position is $20.00 which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate’s experience, skills, and fit with the role’s responsibilities. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. #P02
RN Other
Fallon Health

Registered Nurse- Springfield - M-F / 8:00 AM - 4:30 PM

Fallon Health Springfield, MA
$88,000 / year
Overview About us: Fallon Health is a company that cares. We prioritize our members--always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, we deliver equitable, high-quality coordinated care and are continually rated among the nation’s top health plans for member experience, service, and clinical quality. Fallon Health’s Summit ElderCare® is a Program of All-Inclusive Care for the Elderly–PACE for short. PACE, an alternative to nursing home care, is a program that helps people 55 and older continue living safely at home. At Fallon Health, we believe our individual differences, life experiences, knowledge, self-expression and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE— in the region. Brief Summary of Purpose: Responsible for the effective management and delivery of direct nursing care to PACE participants in any setting utilizing nursing process and adhering to standards of nursing practice. Responsibilities Responsibilities : Reviews and implements Provider’s orders. Conducts nursing assessments according to policy guidelines including physical, psychosocial, behavioral, and MDS-HC as indicated. Involves participants and significant other(s) based on needs and abilities. Delivers care to participants in any setting, including skilled services, based on individualized needs and according to age-appropriate nursing standards. Provides for cultural and diverse needs of participants when providing care. Monitors and evaluates therapeutic interventions. Participates in the development and ongoing review of each participant’s care plan. Delegates participants’ care responsibilities to other members of the health care team, when appropriate. Identifies emergency situations and initiates appropriate nursing orders/interventions. Meets the needs of participants in a timely manner. Participates in the interdisciplinary team (IDT) process and collaborates with IDT members to meet the needs of participants. Consistently documents all aspects of participant care, including significant changes in health status, monthly nurses’ notes and health care teaching in the medical record. Participates in training and orientation of new nursing staff as assigned. Assists in the delivery of other nursing services as assigned. Participates in the nursing “on-call” rotation as assigned. Performs all duties in accordance with FCHP and Summit ElderCare policies and procedures. Participates in Weekend RN On Call rotation Qualifications Education: Graduate of an accredited school of nursing License/Certifications: Current license as a RN in the state of Massachusetts CPR and Alzheimer’s certification, or willingness to be certified within 60 days of hire, is essential. Experience: At least two years of recent experience in the direct care of adults or chronically disabled persons with at least one year caring for a frail or elderly population Ambulatory care or home care experience helpful. Competencies: Demonstrates commitment to the Fallon Community Health Plan Mission, Values and Vision. Specific competencies essential to this position: Customer Focus Commitment Through Action Contributes to Team Performance Focus Upon Quality Other: Reliable Transportation Required. Pay Range Disclosure: In accordance with the Massachusetts Wage Transparency Act, the pay for this position is $88,000 per year , which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate’s experience, skills, and fit with the role’s responsibilities. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. #P01
RN Home Health Other
Fallon Health

RN - Home Care Nurse-Dartmouth

Fallon Health Dartmouth, MA
Overview About us: Fallon Health is a company that cares. We prioritize our members--always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, we deliver equitable, high-quality coordinated care and are continually rated among the nation’s top health plans for member experience, service, and clinical quality. Fallon Health’s Summit ElderCare® is a Program of All-Inclusive Care for the Elderly–PACE for short. PACE, an alternative to nursing home care, is a program that helps people 55 and older continue living safely at home. At Fallon Health, we believe our individual differences, life experiences, knowledge, self-expression and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE— in the region. Brief Summary of Purpose: Responsible for the effective management and delivery of direct nursing care to PACE participants in any setting utilizing nursing process and adhering to standards of nursing practice. Responsibilities Responsibilities : Reviews and implements Provider’s orders. Conducts nursing assessments according to policy guidelines including physical, psychosocial, behavioral, and MDS-HC as indicated. Involves participants and significant other(s) based on needs and abilities. Delivers care to participants in the home setting , including skilled services, based on individualized needs and according to age-appropriate nursing standards. Provides for cultural and diverse needs of participants when providing care. Monitors and evaluates therapeutic interventions. Participates in the development and ongoing review of each participant’s care plan. Delegates and or accepts participants’ care responsibilities to other members of the health care team, when appropriate. Identifies emergency situations and initiates appropriate nursing orders/interventions. Meets the needs of participants in a timely manner. Participates in the interdisciplinary team (IDT) process and collaborates with IDT members to meet the needs of participants. Consistently documents all aspects of participant care, including significant changes in health status, monthly nurses’ notes and health care teaching in the medical record. Participates in training and orientation of new nursing staff as assigned. Assists in the delivery of other nursing services as assigned. Participates in the nursing “on-call” rotation as assigned. Initiates and completes falls, infection, grievance and incident reports Active participant in the site specific committees. Participates in the post IDT huddle and any other additional meetings when required. Any additional tasks deemed necessary by the Clinical Nurse Manager and or Site Director. Assumes the role of the primary nurse, floor or triage nurse per the direction of the Clinical Nurse Manager or Site Director. Performs all duties in accordance with FCHP and Summit ElderCare policies and procedures. Functions independently to administer medications and treatments as ordered by the provider. Functions independently in the home care nurse role. Independent in performing a nursing assessment and executing the plan of care in all settings the participant may be in. Medication administration Performing bladder scans, EKG, Point of Care, and glucometer testing. Qualifications Education: Graduate of an accredited school of nursing License/Certifications: Current license as an RN in the state of Massachusetts CPR and Alzheimer’s certification, or willingness to be certified within 60 days of hire, is essential. Experience: At least two years of recent experience in the direct care of adults or chronically disabled persons, with at least one year caring for a frail or elderly population Ambulatory care or home care experience is helpful. Other: Reliable Transportation Required. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
RN Other
Fallon Health

Temporary to Hire Prior Authorization RN - Hybrid Remote

Fallon Health Worcester, MA
Overview This is 3 months temporary contract position for a Prior Authorization RN. About us: Fallon Health is a company that cares. We prioritize our members—always—making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon Health delivers equitable, high-quality, coordinated care and is continually rated among the nation’s top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)— in the region. Learn more at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn. Brief summary of purpose: The PA Nurse uses a multidisciplinary approach to review service requests (prior-authorizations), focusing on selected complex medical and psychosocial needs of FH members and their families. The PA Nurse is responsible for assuring the receipt of high quality, cost efficient medical outcomes for enrollees. This role works with Medical Directors, Authorization Coordinators, and Service Coordinators to perform pre-service, concurrent, and retrospective reviews for outpatient services such as elective procedures, home health care, DME, nutrition, and genetic testing utilizing established state, federal, and internally developed benefit and clinical coverage criteria against FH polices and protocols. Medical necessity determinations are reviewed with the holistic picture of the member in mind, which requires exceptional attention to detail, proficiency in applying correct criteria, and collaboration with internal and external partners. Responsibilities Primary Job Responsibilities: • Obtain clinical, functional, and psychosocial information from the medical records on site, through remote electronic access, telephonically or by fax in a collaborative effort with other health care professionals, member and/or family• Refers cases to medical review according to policy and procedure• Documents clinical, functional, psychosocial information in the Core System as well as communications regarding the members’ care• Keeps records and submits reports as assigned by the Manager• Refers high-risk cases to the appropriate FH internal teams (ie: Outpatient Case Management, NaviCare, ACO) and/or other community services according to department protocol• Collaborates with attending physicians and health care professionals regarding appropriate utilization of medical services• Completes level of care/service request reviews strictly adhering to regulatory turnaround time guidelines such as, but not limited to, CMS, NCQA, and the DOI• Identifies utilization issues unique to their team assignment and identifies strategies to address/resolve these issues• Issues regulatory and other letters according to the department policies and procedures. • Electronic copies of all denial letters and related documents are kept in the Fallon Health core application and/or the organization’s security accessed drive(s)• Acts as a liaison between Providers, vendors, facilities, members/families, and Fallon Health internal departments. Clarifies policies/procedures and member benefits as needed. Authorizes services, coordinates care, and ensures timeliness and coordination of healthcare services, in compliance with department and regulatory standards, seeking supplemental services when appropriate or when needed• Works with Fallon Health providers/support staff and/or members to facilitate cost-effective, quality care• Requests and obtains relevant clinical information from medical care providers as needed for the clinical review process• Conducts pre-authorization and concurrent clinical reviews requests for services such as DME, elective procedures, Home Health Care, Out of network specialty care, transportation and genetics, against appropriate criteria/guidelines to determine medical necessity, benefit eligibility, and network contract status • Refers all cases that do not meet medical necessity, benefit eligibility, and network contract status criteria to a physician reviewer for consideration, ensuring the timely review of the referred case• Incrementally monitors the effectiveness of established plans of care with defined, measurable goals and objectives and cost-benefit documentation as applicable and modifies the care plan when applicable.• Streamlines the focus of the member’s healthcare needs utilizing the most optimal treatment approach, promoting timely provision of care, enhancing quality of life, and promoting cost-effectiveness of care.• Analyzes and applies CMS always INPT and SDS CPT codes during PA clinical reviews when a surgical procedure is requested as IP LOC• Collaborates with Fallon Health departments to ensure services/items needed to facilitate discharge from a post-acute or hospital setting do not delay discharge• Collaborate with external providers on alternative coverage options when services requested do not meet medical necessity, benefit eligibility, and network contract status criteria• Creates contingency plans for each step of the process to anticipate treatment and service complications, while ensuring that the member attains pre-determined outcomes• Reviews physician reviewers’ determinations for appropriateness and completeness • Communicates determinations to providers and members telephonically and in writing, adhering to corporate/department Communicates determinations to providers and members telephonically and in writing,adhering to corporate/department policy and regulatory guidelines• Will check voicemail at regular intervals throughout the day and returns calls/messages within the same day of receipt• Strictly observes the Fallon Health policies regarding confidentiality of member information, documentation standards, meeting any education requirements, and performs other responsibilities as assigned by department management team• Participates in weekly medical rounds with the leadership team, Medical Directors, and various Fallon Health departments to discuss patient issues and/or concerns. Organizes and presents complex medical cases in a clear and concise oral and written manner• Ensures ad hoc contracts are in place for non-contracted services working in conjunction with FH Network Development team Qualifications Education Graduate from an accredited school of nursing, Associate’s Degree, Bachelors Degree, or advanced degree in nursing required License/Certifications: Active and unrestricted licensure as a Registered Nurse in Massachusetts. Experience: • A minimum of three to five years clinical experience as a Registered Nurse in a clinical setting required. • 2 years’ experience as a Utilization Management/Prior Authorization nurse in a managed care payer preferred.• One year experience as a case manager in a payer or facility setting highly preferred.• Relevant experience may include but not be limited to experience working directly in the field of Home Health Care, Ambulatory Provider Setting, Rehabilitation Nursing Setting, Acute Hospital Setting.• Relevant experience may include, but not be limited to experience processing authorizations for services such as: Outpatient authorization requests such as: o Home Health Careo DMEo Ambulatory Procedureso Genetic Testingo Pharmacyo Nutritional supplies Inpatient authorization requests such as : o Acute Hospital Level of Careo Post-Acute level of care reviews (SNF, Acute Rehab, Long Term Acute Care Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. #P01
RN Other
Fallon Health

Nurse Case Manager - Senior Care Options - Woburn/Reading

Fallon Health Reading, MA
Overview About us: Fallon Health is a company that cares. We prioritize our members—always—making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon Health delivers equitable, high-quality, coordinated care and is continually rated among the nation’s top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)— in the region. Learn more at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn. Brief summary of purpose: The Nurse Case Manager (NCM) is an integral part on an interdisciplinary team focused on care coordination, care management and improving access to and quality of care for Fallon members. NCM seeks to establish telephonic and/or face to face relationships with the member/caregiver(s) to better ensure ongoing service provision and care coordination, consistent with the member specific care plan developed by the NCM and Care Team. Responsibilities may include conducting in home face to face visits for member identified as needing face to face visit interaction and assessments with the goal to coordinate and facilitate services to meet member needs according to benefit structures and available community resources. The NCM may conduct assessments and may determine the number of hours’ members require for MassHealth programs such as the personal care attendant program, adult foster care, group adult foster care, and other programs per product benefits and guidelines. The NCM may utilize an ACD line to support department and incoming/outgoing calls with the goal of first call resolution with each interaction. Responsibilities Note: Job Responsibilities may vary depending upon the member’s Fallon Health Product Member Assessment, Education, and Advocacy Telephonically assesses and case manages a member panel May conduct in home face to face visits for onboarding new enrollees and reassessing members, utilizing a variety of interviewing techniques, including motivational interviewing, and employs culturally sensitive strategies to assess a Member’s clinical/functional status to identify ongoing special conditions and develops and implements an individualized,coordinated care plan, in collaboration with the member, the Clinical Integration team, and Primary Care Providers, Specialist and other community partners, to ensure a cost effective quality outcome Performs medication reconciliations Performs Care Transitions Assessments – per Program and product line processes Utilizing clinical judgment and nursing assessment skills, may complete NaviCare Program Assessment Tools and Minimum Data Set Home Care (MDS HC) Form when a member’s medical/functional status changes that warrants a change in rating category to ensure members are in the correct State defined rating category Maintains up to date knowledge of Program and product line benefits, Plan Evidence of Coverage details, and department policies and processes and follows policies and processes as outlined to be able to provide education to members and providers; performing a member advocacy and education role including but not limited to member rights Serves as an advocate for members to ensure they receive Fallon Health benefits as appropriate and if member needs are identified but not covered by Fallon Health, works with community agencies to facilitate access to programs such as community transportation, food programs, and other services available through senior centers and other external partners Follows department and regulatory standards to authorize and coordinate healthcare services ensuring timeliness in compliance with documented care plan goals and objectives Assesses the Member’s knowledge about the management of current disease processes and medication regimen, provides teaching to increase Member/caregiver knowledge, and works with the members to assist with learning how to self- manage his or her health needs, social needs or behavioral health needs Collaborates with appropriate team members to ensure health education/disease management information is provided as identified Collaborates with the interdisciplinary team in identifying and addressing high risk members Educate members on preventative screenings and other health care procedures such as vaccines, screenings according to established protocols and program processes such initiatives involving Key Metrics outreach Ensures members/PRAs participate in the development and approval of their care plans in conjunction with the interdisciplinary primary care team Strictly observes HIPAA regulations and the Fallon Health Policies regarding confidentiality of member information Supports Quality and Ad-Hoc campaigns Care Coordination and Collaboration Provides culturally appropriate care coordination, i.e. works with interpreters, provides communication approved documents in the appropriate language, and demonstrates culturally appropriate behavior when working with member, family, caregivers, and/or authorized representatives With member/authorized representative(s) collaboration develops member centered care plans by identifying member care needs while completing program assessments and working with the Navigator to ensure the member approves their care plan Manages NaviCare members in conjunction with the Navigator, Behavioral Health Case Manager, Aging Service Access Point Geriatric Support Service Coordinator, contracted Primary Care Providers and others involved/authorized in the member’s care Manages ACO members in conjunction with the Navigator, Social Care Managers, ACO Partners, Community Partners, Behavioral Health Partners and others involved/authorized in the member’s care Monitors progression of member goals and care plan goals, provides feedback and works collaboratively with care team members and work effectively in a team model approach to coordinate a continuum of care consistent with the Member’s health care goals and needs Works collaboratively with Fallon Health Pharmacist, referring members in need of medication review based upon Program process Develops and fosters relationships with members, family, caregivers, PRAs, vendors and providers to ensure good collaboration and coordination by streamlining the focus of the Member’s healthcare needs utilizing the most optimal treatment approach, promoting timely provision of care, enhancing quality of life, and promoting cost-effectiveness of care Actively participates in clinical rounds Provider Partnerships and Collaboration May attend in person care plan meetings with providers and office staff and may lead care plan review with providers and care team as applicable. Demonstrates positive customer service actions and takes responsibility to ensure member and provider requests and needs are met Regulatory Requirements – Actions and Oversight Completes Program Assessments, Notes, Screenings, and Care Plans in the Centralized Enrollee Record according to product regulatory requirements and Program policies and processes Knowledge of and compliance with HEDIS and Medicare 5 Star measure processes, performing member education, outreach, and actions in conjunction with the Navigator and other members of the Clinical Integration and Partner Teams Performs other responsibilities as assigned by the Manager/designee Supports department colleagues, covering and assuming changes in assignment as assigned by Manager/designee Qualifications Education: 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 Certification : Certification in Case Management strongly desired Other : Satisfactory Criminal Offender Record Information (CORI) results and reliable transportation Experience: • 1+ years of clinical experience as a Registered Nurse managing chronically ill members or experience in a coordinated care program required• Understanding of Hospitalization experiences and the impacts and needs after facility discharge required• Experience working face to face with members and providers preferred• Experience with telephonic interviewing skills and working with a diverse population, that may also be Non-English speaking, required• Home Health Care experience preferred• Effective case management and care coordination skills and the ability to assess a member’s activities of daily function and independent activities of daily function and the ability to develop and implement a care plan that meets the member’s need working in partnership with a care team preferred• Familiarity with NCQA case management requirements preferred Performance Requirements including but not limited to: • Excellent communication and interpersonal skills with members and providers via telephone and in person• Exceptional customer service skills and willingness to assist ensuring timely resolution• 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• Working with an interdisciplinary care team as a partner demonstrating respect and value for all roles and is a positive contributor within job role scope and duties• Willingness to learn insurance regulatory and accreditation requirements• Knowledgeable about software systems including but not limited to Microsoft Office Products – Excel, Outlook, and Word • Familiar with Excel spreadsheets to manage work and exposure and familiarity with pivot tables• Accurate and timely data entry• Effective case management and care coordination skills and the ability to assess a member’s activities of daily function and independent activities of daily function and the ability to develop and implement a care plan that meets the member’s need • Knowledge about community resources, levels of care, criteria for levels of care and the ability to appropriately develop and implement a care plan following regulatory guidelines and level of care criteria • Ability to effectively respond and adapt to changing business needs and be an innovative and creative problem solver 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, shifing priorities, ambiguity, and rapid change Demonstrates flexibility Written Communication Is able to write clearly and succinctly in a variety of communication settings and styles. Pay Range Disclosure: In accordance with the Massachusetts Wage Transparency Act, the pay range for this position is $88,000 - $95,000 per year, which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate’s experience, skills, and fit with the role’s responsibilities. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. #P01
CNA Other
Fallon Health

Health Aide - CNA - 20 hours a week ( With Benefits!) - Reading, MA

Fallon Health Reading, MA
Overview About us: Fallon Health is a company that cares. We prioritize our members--always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, we deliver equitable, high-quality coordinated care and are continually rated among the nation’s top health plans for member experience, service, and clinical quality. Fallon Health’s Summit ElderCare® is a Program of All-Inclusive Care for the Elderly–PACE for short. PACE, an alternative to nursing home care, is a program that helps people 55 and older continue living safely at home. At Fallon Health, we believe our individual differences, life experiences, knowledge, self-expression and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE— in the region. Summary: Provides personal care, light housekeeping and assistance with ADLs (Activities of Daily Living) as outlined in each SE participant’s plan of care in participant homes as well as at the PACE center; exercises independent judgement; reports any changes in participant status to the IDT; participates in carrying out infection control precautions and increased cleaning and disinfecting of the PACE center as assigned and in accordance with current CDC guidelines Responsibilities Primary Job Responsibilities: Under the supervision of the RN, assists with the Activities of Daily Living (ADL) needs of participants both at the PACE center and in participants’ homes (i.e., community, Assisted Living Facilities, Rest Homes, Supportive Housing programs, etc.) Contributes to the development of a care plan for participants through interaction with other members of the Interdisciplinary Team. Collaborates with members of the Interdisciplinary Team to assure appropriateness and continuity of care. Carries out non-skilled treatments including, but not limited to vital signs, transfers, toileting, bathing, dressing at the PACE Center and in the community. Assists the Supervisor, Recreational Activities and other activities staff with individual and group programs by helping to plan individual treatment programs, increasing participants’ motivation to participate, assisting participants to participate when needed, and assisting with evaluation of program effectiveness. Assists registered therapists and certified therapy assistants with treatments and participant-specific activities which are ordered for each participant and assigned by the registered therapist including, but not limited to, positioning, transfers, ambulation, and exercises. Maintains a clean and safe working and/or living environment in the PACE center and/or participants’ homes. Assists with meal and snack preparation, serving, feeding as needed, and clean-up. Uses safe techniques in all interactions with participants at the PACE Center and in participants’ homes. Provides accurate and timely documentation in the EMR and other systems as required by SE policies and procedures and/or as assigned by supervisor. Participates in carrying out schedule of daily cleaning and disinfecting of the PACE center in accordance with CDC guidelines for increased precautions Actively participates in distribution of work for health aides to ensure care needs of participants and site tasks are completed timely and appropriately including but not limited to community-based care and center-based tasks, as assigned. Actively participates in regular team meetings for health aides at respective site. Participates in carrying out infection control precautions and increased cleaning and disinfecting of the PACE center as assigned and in accordance with current CDC guidelines. Performs all duties in accordance with FH and Summit ElderCare policies and procedures. Qualifications Education: High school graduate or equivalent. Completion of an approved Home Health Aide or Certified Nursing Assistant Training Program preferred Certification: Certification as a Home Health Aide or Nursing Assistant; CPR and First Aid Certification or willingness to be certified within 60 days of employment is required Experience: One or more years experience working with the elderly in a health care setting. Reliable transportation required. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
CNA Other
Fallon Health

Health Aide - CNA - 20 Hours a week ( With Benefits!) - Lexington, MA

Fallon Health Lexington, MA
Overview About us: Fallon Health is a company that cares. We prioritize our members--always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, we deliver equitable, high-quality coordinated care and are continually rated among the nation’s top health plans for member experience, service, and clinical quality. Fallon Health’s Summit ElderCare® is a Program of All-Inclusive Care for the Elderly–PACE for short. PACE, an alternative to nursing home care, is a program that helps people 55 and older continue living safely at home. At Fallon Health, we believe our individual differences, life experiences, knowledge, self-expression and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE— in the region. Summary: Provides personal care, light housekeeping and assistance with ADLs (Activities of Daily Living) as outlined in each SE participant’s plan of care in participant homes as well as at the PACE center; exercises independent judgement; reports any changes in participant status to the IDT; participates in carrying out infection control precautions and increased cleaning and disinfecting of the PACE center as assigned and in accordance with current CDC guidelines Responsibilities Primary Job Responsibilities: Under the supervision of the RN, assists with the Activities of Daily Living (ADL) needs of participants both at the PACE center and in participants’ homes (i.e., community, Assisted Living Facilities, Rest Homes, Supportive Housing programs, etc.) Contributes to the development of a care plan for participants through interaction with other members of the Interdisciplinary Team. Collaborates with members of the Interdisciplinary Team to assure appropriateness and continuity of care. Carries out non-skilled treatments including, but not limited to vital signs, transfers, toileting, bathing, dressing at the PACE Center and in the community. Assists the Supervisor, Recreational Activities and other activities staff with individual and group programs by helping to plan individual treatment programs, increasing participants’ motivation to participate, assisting participants to participate when needed, and assisting with evaluation of program effectiveness. Assists registered therapists and certified therapy assistants with treatments and participant-specific activities which are ordered for each participant and assigned by the registered therapist including, but not limited to, positioning, transfers, ambulation, and exercises. Maintains a clean and safe working and/or living environment in the PACE center and/or participants’ homes. Assists with meal and snack preparation, serving, feeding as needed, and clean-up. Uses safe techniques in all interactions with participants at the PACE Center and in participants’ homes. Provides accurate and timely documentation in the EMR and other systems as required by SE policies and procedures and/or as assigned by supervisor. Participates in carrying out schedule of daily cleaning and disinfecting of the PACE center in accordance with CDC guidelines for increased precautions Actively participates in distribution of work for health aides to ensure care needs of participants and site tasks are completed timely and appropriately including but not limited to community-based care and center-based tasks, as assigned. Actively participates in regular team meetings for health aides at respective site. Participates in carrying out infection control precautions and increased cleaning and disinfecting of the PACE center as assigned and in accordance with current CDC guidelines. Performs all duties in accordance with FH and Summit ElderCare policies and procedures. Qualifications Education: High school graduate or equivalent. Completion of an approved Home Health Aide or Certified Nursing Assistant Training Program preferred Certification: Certification as a Home Health Aide or Nursing Assistant; CPR and First Aid Certification or willingness to be certified within 60 days of employment is required Experience: One or more years experience working with the elderly in a health care setting. Reliable transportation required. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
CNA Other
Fallon Health

Health Aide / CNA - Attleboro, MA

Fallon Health Attleboro, MA
Overview This is one of the better opportunities out there for Health Aides or CNAs and we will take great care of you! Why?.. + Great benefits! Full-time benefits offering! Health Insurance offerings! Paid Time Off! 12 Holidays! 401K Savings Plan! Tuition Assistance! Vision Care, Life Insurance and more!! + *$20/hr to start and exceeds state pay average! You can also make extra depending of the shifts you can work - read on! + Extra pay for shifts outside normal workday! Extra $3.50/hr weekdays between 7pm and 7am Monday through Friday (shift ends Friday at 7am) Extra $4.00/hr for weekends beginning at 7pm on Friday and ending 7am on Monday. + Mileage Reimbursement! + Respectful and Desirable Health Aide / CNA Work Setting! Predictable Hours! Safe and highly vaccinated work environment including the member population you care for Our Health Aides and staff love the familiarity and relationships establishes with our members You will likely find more autonomy and flexibility than you have in your current role Our model is low-volume and very member and quality care focused About us: Fallon Health is a company that cares. We prioritize our members--always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, we deliver equitable, high-quality coordinated care and are continually rated among the nation’s top health plans for member experience, service, and clinical quality. Fallon Health’s Summit ElderCare® is a Program of All-Inclusive Care for the Elderly–PACE for short. PACE, an alternative to nursing home care, is a program that helps people 55 and older continue living safely at home. At Fallon Health, we believe our individual differences, life experiences, knowledge, self-expression and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE— in the region. Summary: Provides personal care, light housekeeping and assistance with ADLs (Activities of Daily Living) as outlined in each SE participant’s plan of care in participant homes as well as at the PACE center; exercises independent judgement; reports any changes in participant status to the IDT; participates in carrying out infection control precautions and increased cleaning and disinfecting of the PACE center as assigned and in accordance with current CDC guidelines Responsibilities Under the supervision of the RN, assists with the Activities of Daily Living (ADL) needs of participants both at the PACE center and in participants’ homes (i.e., community, Assisted Living Facilities, Rest Homes, Supportive Housing programs, etc.) Contributes to the development of a care plan for participants through interaction with other members of the Interdisciplinary Team. Collaborates with members of the Interdisciplinary Team to assure appropriateness and continuity of care. Carries out non-skilled treatments including, but not limited to vital signs, transfers, toileting, bathing, dressing at the PACE Center and in the community. Assists the Supervisor, Recreational Activities and other activities staff with individual and group programs by helping to plan individual treatment programs, increasing participants’ motivation to participate, assisting participants to participate when needed, and assisting with evaluation of program effectiveness. Assists registered therapists and certified therapy assistants with treatments and participant-specific activities which are ordered for each participant and assigned by the registered therapist including, but not limited to, positioning, transfers, ambulation, and exercises. Maintains a clean and safe working and/or living environment in the PACE center and/or participants’ homes. Assists with meal and snack preparation, serving, feeding as needed, and clean-up. Uses safe techniques in all interactions with participants at the PACE Center and in participants’ homes. Provides accurate and timely documentation in the EMR and other systems as required by SE policies and procedures and/or as assigned by supervisor. Participates in carrying out schedule of daily cleaning and disinfecting of the PACE center in accordance with CDC guidelines for increased precautions Actively participates in distribution of work for health aides to ensure care needs of participants and site tasks are completed timely and appropriately including but not limited to community-based care and center-based tasks, as assigned Actively participates in regular team meetings for health aides at respective site Participates in carrying out infection control precautions and increased cleaning and disinfecting of the PACE center as assigned and in accordance with current CDC guidelines Performs all duties in accordance with FH and Summit ElderCare policies and procedures. Qualifications Education: Completion of an approved Home Health Aide or Certified Nursing Assistant Training Program is highly desirable, but we will accept equivalent work experience in lieu of certificate. Certification: Certification as a Home Health Aide or Nursing Assistant is desired. Reliable Transportation Required. Experience: One year of experience working with a frail and/or older adult population preferably in a PACE program. If under one year, must complete Summit Eldercare training program for health aides prior to working with participants independently. Must complete a standardized set of Summit Eldercare competencies for Health Aides on an annual basis. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
CNA Home Health Other
Fallon Health

Home Health Aide / CNA - Worcester - Great hours, benefits and high Pay!

Fallon Health Worcester, MA
Overview Several shifts available - let us know what works best for you when you apply! This is one of the better opportunities out there for Health Aides or CNAs and we will take great care of you! Why?.. + Great benefits! Full-time benefits offering! Health Insurance offerings! Paid Time Off! 10 Holidays! 401K Savings Plan! Tuition Assistance! Vision Care, Life Insurance and more!! + *$20/hr to start and far exceeds state pay average! You can also make extra depending of the shifts you can work - read on! + Extra pay for shifts outside normal workday! Extra $3.50/hr weekdays between 7pm and 7am Monday through Friday (shift ends Friday at 7am) Extra $4.00/hr for weekends beginning at 7pm on Friday and ending 7am on Monday. + Mileage Reimbursement! + Respectful and Desirable Health Aide / CNA Work Setting! Predictable Hours! Safe and highly vaccinated work environment including the member population you care for Our Health Aides and staff love the familiarity and relationships establishes with our members You will likely find more autonomy and flexibility than you have in your current role Our model is low-volume and very member and quality care focused About us: Fallon Health is a company that cares. We prioritize our members--always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, we deliver equitable, high-quality coordinated care and are continually rated among the nation’s top health plans for member experience, service, and clinical quality. Fallon Health’s Summit ElderCare® is a Program of All-Inclusive Care for the Elderly–PACE for short. PACE, an alternative to nursing home care, is a program that helps people 55 and older continue living safely at home. At Fallon Health, we believe our individual differences, life experiences, knowledge, self-expression and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE— in the region. Summary: Provides personal care, light housekeeping and assistance with ADLs (Activities of Daily Living) as outlined in each SE participant’s plan of care in participant homes as well as at the PACE center; exercises independent judgement; reports any changes in participant status to the IDT; participates in carrying out infection control precautions and increased cleaning and disinfecting of the PACE center as assigned and in accordance with current CDC guidelines Responsibilities Under the supervision of the RN, assists with the Activities of Daily Living (ADL) needs of participants both at the PACE center and in participants’ homes (i.e., community, Assisted Living Facilities, Rest Homes, Supportive Housing programs, etc.) Contributes to the development of a care plan for participants through interaction with other members of the Interdisciplinary Team. Collaborates with members of the Interdisciplinary Team to assure appropriateness and continuity of care. Carries out non-skilled treatments including, but not limited to vital signs, transfers, toileting, bathing, dressing at the PACE Center and in the community. Assists the Supervisor, Recreational Activities and other activities staff with individual and group programs by helping to plan individual treatment programs, increasing participants’ motivation to participate, assisting participants to participate when needed, and assisting with evaluation of program effectiveness. Assists registered therapists and certified therapy assistants with treatments and participant-specific activities which are ordered for each participant and assigned by the registered therapist including, but not limited to, positioning, transfers, ambulation, and exercises. Maintains a clean and safe working and/or living environment in the PACE center and/or participants’ homes. Assists with meal and snack preparation, serving, feeding as needed, and clean-up. Uses safe techniques in all interactions with participants at the PACE Center and in participants’ homes. Provides accurate and timely documentation in the EMR and other systems as required by SE policies and procedures and/or as assigned by supervisor. Participates in carrying out schedule of daily cleaning and disinfecting of the PACE center in accordance with CDC guidelines for increased precautions Actively participates in distribution of work for health aides to ensure care needs of participants and site tasks are completed timely and appropriately including but not limited to community-based care and center-based tasks, as assigned Actively participates in regular team meetings for health aides at respective site Participates in carrying out infection control precautions and increased cleaning and disinfecting of the PACE center as assigned and in accordance with current CDC guidelines Performs all duties in accordance with FH and Summit ElderCare policies and procedures. Qualifications Education: Completion of an approved Home Health Aide or Certified Nursing Assistant Training Program is highly desirable, but we will accept equivalent work experience in lieu of certificate. Certification: Certification as a Home Health Aide or Nursing Assistant is desired. Reliable Transportation Required. Experience: One year of experience working with a frail and/or older adult population preferably in a PACE program. If under one year, must complete Summit Eldercare training program for health aides prior to working with participants independently. Must complete a standardized set of Summit Eldercare competencies for Health Aides on an annual basis. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
CNA Home Health Other
Fallon Health

Home Health Aide / CNA - Framingham - Great hours, benefits and high Pay!

Fallon Health Framingham, MA
Overview Several shifts available - let us know what works best for you when you apply! This is one of the better opportunities out there for Health Aides or CNAs and we will take great care of you! Why?.. + Great benefits! Full-time benefits offering! Health Insurance offerings! Paid Time Off! 10 Holidays! 401K Savings Plan! Tuition Assistance! Vision Care, Life Insurance and more!! + *$20/hr to start and far exceeds state pay average! You can also make extra depending of the shifts you can work - read on! + Extra pay for shifts outside normal workday! Extra $3.50/hr weekdays between 7pm and 7am Monday through Friday (shift ends Friday at 7am) Extra $4.00/hr for weekends beginning at 7pm on Friday and ending 7am on Monday. + Mileage Reimbursement! + Respectful and Desirable Health Aide / CNA Work Setting! Predictable Hours! Safe and highly vaccinated work environment including the member population you care for Our Health Aides and staff love the familiarity and relationships establishes with our members You will likely find more autonomy and flexibility than you have in your current role Our model is low-volume and very member and quality care focused About us: Fallon Health is a company that cares. We prioritize our members--always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, we deliver equitable, high-quality coordinated care and are continually rated among the nation’s top health plans for member experience, service, and clinical quality. Fallon Health’s Summit ElderCare® is a Program of All-Inclusive Care for the Elderly–PACE for short. PACE, an alternative to nursing home care, is a program that helps people 55 and older continue living safely at home. At Fallon Health, we believe our individual differences, life experiences, knowledge, self-expression and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE— in the region. Summary: Provides personal care, light housekeeping and assistance with ADLs (Activities of Daily Living) as outlined in each SE participant’s plan of care in participant homes as well as at the PACE center; exercises independent judgement; reports any changes in participant status to the IDT; participates in carrying out infection control precautions and increased cleaning and disinfecting of the PACE center as assigned and in accordance with current CDC guidelines Responsibilities Under the supervision of the RN, assists with the Activities of Daily Living (ADL) needs of participants both at the PACE center and in participants’ homes (i.e., community, Assisted Living Facilities, Rest Homes, Supportive Housing programs, etc.) Contributes to the development of a care plan for participants through interaction with other members of the Interdisciplinary Team. Collaborates with members of the Interdisciplinary Team to assure appropriateness and continuity of care. Carries out non-skilled treatments including, but not limited to vital signs, transfers, toileting, bathing, dressing at the PACE Center and in the community. Assists the Supervisor, Recreational Activities and other activities staff with individual and group programs by helping to plan individual treatment programs, increasing participants’ motivation to participate, assisting participants to participate when needed, and assisting with evaluation of program effectiveness. Assists registered therapists and certified therapy assistants with treatments and participant-specific activities which are ordered for each participant and assigned by the registered therapist including, but not limited to, positioning, transfers, ambulation, and exercises. Maintains a clean and safe working and/or living environment in the PACE center and/or participants’ homes. Assists with meal and snack preparation, serving, feeding as needed, and clean-up. Uses safe techniques in all interactions with participants at the PACE Center and in participants’ homes. Provides accurate and timely documentation in the EMR and other systems as required by SE policies and procedures and/or as assigned by supervisor. Participates in carrying out schedule of daily cleaning and disinfecting of the PACE center in accordance with CDC guidelines for increased precautions Actively participates in distribution of work for health aides to ensure care needs of participants and site tasks are completed timely and appropriately including but not limited to community-based care and center-based tasks, as assigned Actively participates in regular team meetings for health aides at respective site Participates in carrying out infection control precautions and increased cleaning and disinfecting of the PACE center as assigned and in accordance with current CDC guidelines Performs all duties in accordance with FH and Summit ElderCare policies and procedures. Qualifications Education: Completion of an approved Home Health Aide or Certified Nursing Assistant Training Program is highly desirable, but we will accept equivalent work experience in lieu of certificate. Certification: Certification as a Home Health Aide or Nursing Assistant is desired. Reliable Transportation Required. Experience: One year of experience working with a frail and/or older adult population, preferably in a PACE program. If under one year, must complete Summit Eldercare training program for health aides prior to working with participants independently. Must complete a standardized set of Summit Eldercare competencies for Health Aides on an annual basis. Pay Range Disclosure: In accordance with the Massachusetts Wage Transparency Act, the pay range for this position is $20.00 to $24.00 per hour , which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate’s experience, skills, and fit with the role’s responsibilities. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
CNA Home Health Other
Fallon Health

CNA / Home Health Aide - Worcester/Framingham - Per Diem - Flexible Schedule - Great Pay!

Fallon Health Framingham, MA
Overview This is one of the better opportunities out there for Health Aides or CNAs and we will take great care of you! Why?.. + *$20/hr to start and exceeds state pay average! You can also make extra depending of the shifts you can work. + Mileage Reimbursement! + Respectful and Desirable Health Aide / CNA Work Setting! Predictable Hours! Safe and highly vaccinated work environment including the member population you care for Our Health Aides and staff love the familiarity and relationships establishes with our members You will likely find more autonomy and flexibility than you have in your current role Our model is low-volume and very member and quality care focused About us: Fallon Health is a company that cares. We prioritize our members--always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, we deliver equitable, high-quality coordinated care and are continually rated among the nation’s top health plans for member experience, service, and clinical quality. Fallon Health’s Summit ElderCare® is a Program of All-Inclusive Care for the Elderly–PACE for short. PACE, an alternative to nursing home care, is a program that helps people 55 and older continue living safely at home. At Fallon Health, we believe our individual differences, life experiences, knowledge, self-expression and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE— in the region. Summary: Provides personal care, light housekeeping and assistance with ADLs (Activities of Daily Living) as outlined in each SE participant’s plan of care in participant homes as well as at the PACE center; exercises independent judgement; reports any changes in participant status to the IDT; participates in carrying out infection control precautions and increased cleaning and disinfecting of the PACE center as assigned and in accordance with current CDC guidelines Responsibilities Under the supervision of the RN, assists with the Activities of Daily Living (ADL) needs of participants both at the PACE center and in participants’ homes (i.e., community, Assisted Living Facilities, Rest Homes, Supportive Housing programs, etc.) Contributes to the development of a care plan for participants through interaction with other members of the Interdisciplinary Team. Collaborates with members of the Interdisciplinary Team to assure appropriateness and continuity of care. Carries out non-skilled treatments including, but not limited to vital signs, transfers, toileting, bathing, dressing at the PACE Center and in the community. Assists the Supervisor, Recreational Activities and other activities staff with individual and group programs by helping to plan individual treatment programs, increasing participants’ motivation to participate, assisting participants to participate when needed, and assisting with evaluation of program effectiveness. Assists registered therapists and certified therapy assistants with treatments and participant-specific activities which are ordered for each participant and assigned by the registered therapist including, but not limited to, positioning, transfers, ambulation, and exercises. Maintains a clean and safe working and/or living environment in the PACE center and/or participants’ homes. Assists with meal and snack preparation, serving, feeding as needed, and clean-up. Uses safe techniques in all interactions with participants at the PACE Center and in participants’ homes. Provides accurate and timely documentation in the EMR and other systems as required by SE policies and procedures and/or as assigned by supervisor. Participates in carrying out schedule of daily cleaning and disinfecting of the PACE center in accordance with CDC guidelines for increased precautions Actively participates in distribution of work for health aides to ensure care needs of participants and site tasks are completed timely and appropriately including but not limited to community-based care and center-based tasks, as assigned Actively participates in regular team meetings for health aides at respective site Participates in carrying out infection control precautions and increased cleaning and disinfecting of the PACE center as assigned and in accordance with current CDC guidelines Performs all duties in accordance with FH and Summit ElderCare policies and procedures. Qualifications Education: Completion of an approved Home Health Aide or Certified Nursing Assistant Training Program is highly desirable, but we will accept equivalent work experience in lieu of certificate. Certification: Certification as a Home Health Aide or Nursing Assistant is desired. Reliable Transportation Required. Experience: One year of experience working with a frail and/or older adult population preferably in a PACE program. If under one year, must complete Summit Eldercare training program for health aides prior to working with participants independently. Must complete a standardized set of Summit Eldercare competencies for Health Aides on an annual basis. Pay Range Disclosure: In accordance with the Massachusetts Wage Transparency Act, the pay range for this position is $20.00 to $24.00 per hour , which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate’s experience, skills, and fit with the role’s responsibilities. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
LPN Other
Fallon Health

LPN Springfield

Fallon Health Leominster, MA
Overview About us: Fallon Health is a company that cares. We prioritize our members--always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, we deliver equitable, high-quality coordinated care and are continually rated among the nation’s top health plans for member experience, service, and clinical quality. Fallon Health’s Summit ElderCare® is a Program of All-Inclusive Care for the Elderly–PACE for short. PACE, an alternative to nursing home care, is a program that helps people 55 and older continue living safely at home. At Fallon Health, we believe our individual differences, life experiences, knowledge, self-expression and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE— in the region. Brief Summary of Purpose: The SE Licensed Practical Nurse will be an active member of the Summit ElderCare Care Team to ensure participants receive high quality and timely care and support whether at the PACE center or in the community. The SE Licensed Practical Nurse will carry out nursing tasks as assigned by his/her direct RN Manager as well as SE Providers and will ensure appropriate follow through and documentation in a timely manner. Responsibilities Responsibilities : The SE Licensed Practical Nurse will be a generalized nursing role within the PACE center that will implement plans of care that have been formulated by the Provider and Primary RN in collaboration with the Interdisciplinary Team. This role will report to and be supervised by the respective RN Manager (Clinical Manager or Home Care Manager) depending on the PACE site. The SE Licensed Practical Nurse will carry out nursing tasks as assigned by their direct supervisor and in accordance with their license (i.e., receive calls from participants and their caregivers, appropriately triage each call and conduct appropriate follow up including timely documentation in the medical record, administration of prescribed medications to participants attending the PACE center, recording vitals, carrying out treatments and wound care as assigned for participants attending the day center, make frequent home visits in the community to evaluate the home environment, fill weekly medication packs, record vitals, administer prescribed treatments, deliver relevant health teaching for participants and their caregivers, and make recommendations to the IDT regarding unmet participant needs, etc.). The SE Licensed Practical Nurse will work closely with their respective supervisor as well as the other nursing staff to coordinate all care for SE participants. Assignments will require occasional or frequent travel throughout the service area to/from participants’ homes and contracted facilities. Qualifications Education: Graduate of an accredited school of nursing License/Certifications: Valid license to perform Practical Nursing in the Commonwealth of Massachusetts Access to reliable transportation to perform work throughout the PACE center’s service area (30-mile radius) when needed. Willingness to occasionally assist other SE PACE centers either in person or remotely, as appropriate, when there is an opening or a gap in coverage. Experience: At minimum, three years’ nursing experience in a primary care practice or long-term care facility or similar clinical setting At minimum, one year working in a nursing capacity with frail elders Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
LPN Per Diem
Fallon Health

LPN - Per Diem - Lowell, MA

Fallon Health Lowell, MA
Overview About us: Fallon Health is a company that cares. We prioritize our members--always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, we deliver equitable, high-quality coordinated care and are continually rated among the nation’s top health plans for member experience, service, and clinical quality. Fallon Health’s Summit ElderCare® is a Program of All-Inclusive Care for the Elderly–PACE for short. PACE, an alternative to nursing home care, is a program that helps people 55 and older continue living safely at home. At Fallon Health, we believe our individual differences, life experiences, knowledge, self-expression and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE— in the region. Brief Summary of Purpose: The SE Licensed Practical Nurse will be an active member of the Summit ElderCare Care Team to ensure participants receive high quality and timely care and support whether at the PACE center or in the community. The SE Licensed Practical Nurse will carry out nursing tasks as assigned by his/her direct RN Manager as well as SE Providers and will ensure appropriate follow through and documentation in a timely manner. Responsibilities Responsibilities : The SE Licensed Practical Nurse will be a generalized nursing role within the PACE center that will implement plans of care that have been formulated by the Provider and Primary RN in collaboration with the Interdisciplinary Team. This role will report to and be supervised by the respective RN Manager (Clinical Manager or Home Care Manager) depending on the PACE site. The SE Licensed Practical Nurse will carry out nursing tasks as assigned by their direct supervisor and in accordance with their license (i.e., receive calls from participants and their caregivers, appropriately triage each call and conduct appropriate follow up including timely documentation in the medical record, administration of prescribed medications to participants attending the PACE center, recording vitals, carrying out treatments and wound care as assigned for participants attending the day center, make frequent home visits in the community to evaluate the home environment, fill weekly medication packs, record vitals, administer prescribed treatments, deliver relevant health teaching for participants and their caregivers, and make recommendations to the IDT regarding unmet participant needs, etc.). The SE Licensed Practical Nurse will work closely with their respective supervisor as well as the other nursing staff to coordinate all care for SE participants. Assignments will require occasional or frequent travel throughout the service area to/from participants’ homes and contracted facilities. Qualifications Education: Graduate of an accredited school of nursing License/Certifications: Valid license to perform Practical Nursing in the Commonwealth of Massachusetts Access to reliable transportation to perform work throughout the PACE center’s service area (30-mile radius) when needed. Willingness to occasionally assist other SE PACE centers either in person or remotely, as appropriate, when there is an opening or a gap in coverage. Experience: At minimum, three years’ nursing experience in a primary care practice or long-term care facility or similar clinical setting At minimum, one year working in a nursing capacity with frail elders Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
LPN Other
Fallon Health

LPN or RN - **High Pay - Part Time (24-32) - Temporary- 3 - 9 months **

Fallon Health Webster, MA
Overview About us: Fallon Health is a company that cares. We prioritize our members--always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, we deliver equitable, high-quality coordinated care and are continually rated among the nation’s top health plans for member experience, service, and clinical quality. Fallon Health’s Summit ElderCare® is a Program of All-Inclusive Care for the Elderly–PACE for short. PACE, an alternative to nursing home care, is a program that helps people 55 and older continue living safely at home. At Fallon Health, we believe our individual differences, life experiences, knowledge, self-expression and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs, including Medicare, Medicaid, and PACE— in the region. Brief Summary of Purpose: Responsible for the effective management and delivery of direct nursing care to PACE participants in any setting, utilizing the nursing process and adhering to standards of nursing practice. Responsibilities Responsibilities : Reviews and implements Provider’s orders. Conducts nursing assessments according to policy guidelines, including physical, psychosocial, behavioral, and MDS-HC as indicated. Involves participants and significant other(s) based on needs and abilities. Delivers care to participants in any setting, including skilled services, based on individualized needs and according to age-appropriate nursing standards. Provides for cultural and diverse needs of participants when providing care. Monitors and evaluates therapeutic interventions. Participates in the development and ongoing review of each participant’s care plan. Delegates participants’ care responsibilities to other members of the health care team, when appropriate. Identifies emergency situations and initiates appropriate nursing orders/interventions. Meets the needs of participants in a timely manner. Participates in the interdisciplinary team (IDT) process and collaborates with IDT members to meet the needs of participants. Consistently documents all aspects of participant care, including significant changes in health status, monthly nurses’ notes and health care teaching in the medical record. Participates in training and orientation of new nursing staff as assigned. Assists in the delivery of other nursing services as assigned. Participates in the nursing “on-call” rotation as assigned. Performs all duties in accordance with FCHP and Summit ElderCare policies and procedures. Participates in Weekend RN On Call rotation Qualifications Education: Graduate of an accredited school of nursing License/Certifications: Current license as an RN in the state of Massachusetts CPR and Alzheimer’s certification, or willingness to be certified within 60 days of hire, is essential. Experience: At least two years of recent experience in the direct care of adults or chronically disabled persons, with at least one year caring for a frail or elderly population Ambulatory care or home care experience is helpful. Other: Reliable Transportation Required. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. #P01
RN Other
Fallon Health

RN - Nurse **High Pay - Part Time (24-32) - Temporary- 3 - 6 months **

Fallon Health Webster, MA
Overview About us: Fallon Health is a company that cares. We prioritize our members--always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, we deliver equitable, high-quality coordinated care and are continually rated among the nation’s top health plans for member experience, service, and clinical quality. Fallon Health’s Summit ElderCare® is a Program of All-Inclusive Care for the Elderly–PACE for short. PACE, an alternative to nursing home care, is a program that helps people 55 and older continue living safely at home. At Fallon Health, we believe our individual differences, life experiences, knowledge, self-expression and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs, including Medicare, Medicaid, and PACE— in the region. Brief Summary of Purpose: Responsible for the effective management and delivery of direct nursing care to PACE participants in any setting, utilizing the nursing process and adhering to standards of nursing practice. Responsibilities Responsibilities : Reviews and implements Provider’s orders. Conducts nursing assessments according to policy guidelines, including physical, psychosocial, behavioral, and MDS-HC as indicated. Involves participants and significant other(s) based on needs and abilities. Delivers care to participants in any setting, including skilled services, based on individualized needs and according to age-appropriate nursing standards. Provides for cultural and diverse needs of participants when providing care. Monitors and evaluates therapeutic interventions. Participates in the development and ongoing review of each participant’s care plan. Delegates participants’ care responsibilities to other members of the health care team, when appropriate. Identifies emergency situations and initiates appropriate nursing orders/interventions. Meets the needs of participants in a timely manner. Participates in the interdisciplinary team (IDT) process and collaborates with IDT members to meet the needs of participants. Consistently documents all aspects of participant care, including significant changes in health status, monthly nurses’ notes and health care teaching in the medical record. Participates in training and orientation of new nursing staff as assigned. Assists in the delivery of other nursing services as assigned. Participates in the nursing “on-call” rotation as assigned. Performs all duties in accordance with FCHP and Summit ElderCare policies and procedures. Participates in Weekend RN On Call rotation Qualifications Education: Graduate of an accredited school of nursing License/Certifications: Current license as an RN in the state of Massachusetts CPR and Alzheimer’s certification, or willingness to be certified within 60 days of hire, is essential. Experience: At least two years of recent experience in the direct care of adults or chronically disabled persons, with at least one year caring for a frail or elderly population Ambulatory care or home care experience is helpful. Other: Reliable Transportation Required. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.