Clinical Assessor, Registered Nurse - (Hybrid Remote -Fall River, MA)

About the role

The Commonwealth of Massachusetts Executive Office of Health and Human Services (EOHHS), through the MassHealth Office of Long-Term Services and Supports (LTSS), provides a robust system of care for individuals of all ages with disabilities and chronic conditions. The program is designed to help Massachusetts residents live with independence and dignity, participate in their communities, and improve their overall quality of life. As the Public Assessors Option (PAO), Maximus provides education to providers, conducts comprehensive in-person assessments, and offers call center support for the following LTSS programs: Adult Day Health (ADH), Adult Foster Care (AFC), Group Adult Foster Care (GAFC), and Personal Care Attendant (PCA).

Responsibilities

• Conducts on-site, video call and/or telephonic assessments to determine an individual’s needs for services and supports, eligibility, level of care or related outcome
• Responsible for completing medical and/or behavioral health assessments within contract requirements
• Conducts assessments using standardized tools (UCA, TTT) to identify medical, functional, and social needs
• Develops and manages service plans for complex or high-acuity members, coordinating with healthcare providers, case managers, and community resources
• Evaluates eligibility for recommended referrals to other professionals or agencies
• Maintains compliance with state and federal regulations, Medicaid/LTSS program guidelines, and electronic health record systems
• Collaborates with care teams to revise care plans as needs change, ensuring alignment with member goals
• Provides education to members, families, and caregivers on available services and options
• Documents assessments and care activities accurately to support billing, compliance, and quality reporting
• Advocates for members to help them remain in preferred living environments and maintain independence

Requirements

• Current Registered Nurse (RN) license valid in the state of practice is required
• High School Degree or equivalent required
• Minimum 2 years of clinical experience required
• An active, unencumbered Registered Nurse (RN) license in the state of Massachusetts
• Minimum of two (2) years of relevant post-graduate clinical experience as a Registered Nurse
• Experience working with vulnerable populations, including individuals with behavioral health needs, intellectual and developmental disabilities (I/DD), and those requiring long-term services and supports (LTSS)
• Experience conducting clinical or functional assessments in home or community-based settings, such as behavioral health evaluations, level of care determinations, or utilization reviews
• Knowledge of community-based services, care coordination, and person-centered care planning
• Familiarity with MassHealth programs, LTSS, and Home and Community-Based Services (HCBS) waiver programs
• Proficiency in Microsoft Office applications
• Experience documenting assessments in electronic systems

Qualifications

• Minimum of two (2) years of relevant post-graduate clinical experience as a Registered Nurse
• Experience working with vulnerable populations, including individuals with behavioral health needs, intellectual and developmental disabilities (I/DD), and those requiring long-term services and supports (LTSS)
• Experience conducting clinical or functional assessments in home or community-based settings, such as behavioral health evaluations, level of care determinations, or utilization reviews
• Knowledge of community-based services, care coordination, and person-centered care planning
• Familiarity with MassHealth programs, LTSS, and Home and Community-Based Services (HCBS) waiver programs
• Proficiency in Microsoft Office applications
• Experience documenting assessments in electronic systems

Skills

• Person First standards
• HIPAA guidelines
• Company confidentiality policies and procedures
• Microsoft Office applications
• Electronic health record systems

Benefits

• Work/Life Balance Support
• Competitive Compensation
• Comprehensive Insurance Coverage
• Future Planning
• Paid Time Off Package
• Holistic Wellness Support
• Recognition Platform
• Tuition Reimbursement
• Employee Perks and Discounts
• Maximus Wellness Program and Resources
• Professional Development Opportunities
• Licensures and Certifications

Pay

Annual salary is just one component of Maximus's total compensation package. Other rewards may include short- and long-term incentives as well as program-specific awards. Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off.

Schedule

Travel may be required based on program contract requirements. This position requires independent management of a daily travel schedule throughout the assigned region during standard business hours (Monday–Friday, 8:00 AM–5:00 PM).