MDS Nurse RN

Written by jtranford - - Comments Off on MDS Nurse RN
Harbor Health
August 11, 2021
Mattapan, Massachusetts
Job Type


MDS Nurse RN

Per Diem

Mattapan, MA, US

7 days agoRequisition ID: 1593

The MDS Nurse is responsible for ensuring that potential and/or current PACE participants are meeting the clinical requirements of PACE membership according to the Minimum Data Set-Home Care (MDS-HC) Clinical Assessment. The MDS Nurse will be responsible for managing all aspects of the clinical assessment process including performing assessments either in person or via phone, submitting assessments via the State’s website (Virtual Gateway), responding to MassHealth Nurses’ requests, providing Interdisciplinary Teams (IDTs) with all pertinent new enrollee information and documents, and maintaining documentation of completed work.

The team of MDS Nurses work together to service an area that includes Bristol, Middlesex, Norfolk, Plymouth and Suffolk counties.  Position is Per Diem, as needed, to cover open shifts, leaves etc. 

Job Duties: 

  • Performs all necessary actions to complete initial and annual state required clinical assessments including in-person or electronic intakes, obtaining necessary information from various sources, completing and submitting assessments for state review, correcting and resubmitting assessments until final approval is received, and saving final approvals.
  • Completes reassessment and submission of expired clinical assessments.
  • Maintains detailed records of all submissions and state responses.
  • Maintains a detailed understanding of the state’s PACE clinical requirements.
  • Collaborates with other departments to ensure successful submission of state clinical assessments and new participant enrollment transitions.
  • Follows up on additional requested medical information needed prior to applicant enrollment.
  • Initiates new participant medical record in the Electronic Medical Record (EMR) .
  • Assures presence of completed and signed Health Care Proxy, Medical Release Form, and other designated forms.
  • Provides detailed clinical information of potential applicants to IDTs to assist them in preparing for the transition of new enrollees.
  • Provides obtained applicant documents to Medical Records for scanning into the EMR including  medical record release form, Health Care Proxy (HCP), Power of Attorney (POA), Wills, Medical Records, etc.
  • Must be able to meet work and process deadlines set by the PACE Membership Manager.

Required/Preferred Education, Experience and Skills:

  • Associates Degree in Nursing required
  • Current MA Registered Nurse (RN) License  and BLS required
  • One year of experience working with an elder population preferred, 2 years of  experience in a healthcare setting preferred
  • Ability to identify ADL and Skilled Nursing needs required
  • Proficiency with Microsoft Word, Outlook, and Excel and willingness and ability to learn and use new software required
  • Must be able to timely travel to necessary locations (participant’s home, agencies, other ESP sites, etc.) to perform duties as required in program service areas.
  • Proven ability to resolve problems creatively
  • Excellent verbal and written communication skills and organizational skills
  • Ability to work independently and as a member of a Team
  • Must be able to utilize critical thinking skills to problem solve throughout the day
  • Experience with the MA Minimum Data Set – Home Care Clinical Assessment preferred
  • Experience using an Electronic Medical Record (EMR), specifically NextGen preferred

Harbor Health is an Equal Opportunity Employer M/F/V/D. 

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