Clinical Assessor, Registered Nurse - (Hybrid Remote - Springfield, 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.
Responsibilities
- Responsible for completing medical and/or behavioral health assessments within contract requirements
- 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
- Performs all job duties in compliance with Person First standards, HIPAA guidelines, and company confidentiality policies and procedures
- Travel may be required based on program contract requirements
- Conduct assessments using standardized tools (UCA, TTT) to identify medical, functional, and social needs
- Develop and manage service plans for complex or high-acuity members, coordinating with healthcare providers, case managers, and community resources
- Evaluate eligibility for recommended referrals to other professionals or agencies
- Maintain compliance with state and federal regulations, Medicaid/LTSS program guidelines, and electronic health record systems
- Collaborate with care teams to revise care plans as needs change, ensuring alignment with member goals
- Provide education to members, families, and caregivers on available services and options
- Document assessments and care activities accurately to support billing, compliance, and quality reporting
- Advocate 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 20 Mbps download speeds/50 Mbps for shared internet connectivity
- Minimum 5 Mbps upload speeds
- Private and secure workspace
Skills
- Person First standards
- HIPAA guidelines
- Electronic health record systems
- MassHealth programs, LTSS, and Home and Community-Based Services (HCBS) waiver programs
- Microsoft Office applications
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. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances.
Schedule
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).