NJ - Intake Nurse

About Abby Care

Aby Care is building the leading AI-native platform for family-led care. America faces a growing care crisis, with millions needing care at home but lacking the tools, training, or recognition they deserve. Abby Care aims to harness the power of family caregivers to improve care quality and drive better outcomes.

The Role

The Intake Nurse serves as the clinical gatekeeper for new referrals and prospective clients, ensuring patients meet payer, regulatory, agency, and clinical eligibility requirements before admission. This role collaborates with various teams to evaluate referrals, assess patient needs, and support timely admissions.

Key Responsibilities

• Review incoming referrals, leads, and prospective patient inquiries for clinical appropriateness.
• Evaluate medical records, physician orders, diagnoses, medications, treatment plans, and supporting documentation.
• Determine whether requested services meet agency admission criteria and payer requirements.
• Absess eligibility for skilled nursing, personal care, home health aide/family caregiver, or specialty programs.
• Identify clinical risks, safety concerns, and service limitations that may impact admission.
• Escalate complex clinical cases to the Director of Nursing or Clinical Leadership as needed.
• Document qualification decisions and rationale for tracking purposes.

Clinical Lead Management

• Conduct telephone-based clinical screenings with patients, caregivers, referral sources, and physicians.
• Gather missing clinical information needed to complete qualification reviews.
• Prioritize referrals based on urgency, acuity, and service availability.
• Maintain timely response times for all incoming leads.

Payer & Regulatory Compliance

• Verify referrals meet Medicare, Medicaid, managed care, private duty, and agency-specific requirements.
• Ensure physician documentation and orders support requested services.
• Maintain knowledge of state regulations, home health conditions of participation, and payer authorization requirements.
• Aid with prior authorization clinical documentation as needed.

Admission Coordination

• Collaborate with scheduling and operations teams to coordinate Start of Care (SOC) visits.
• Work with Family Growth Associates to communicate admission decisions to referral sources and internal stakeholders.
• Ensure all required documentation is completed prior to admission.
• Support smooth handoff to assigned case managers and field clinicians.

Quality & Process Improvement

• Monitor referral outcomes and identify trends affecting admissions.
• Participate in intake process improvement initiatives.
• Assist with development and maintenance of admission criteria and clinical screening tools.
• Support quality assurance audits related to intake documentation.

The Requirements

• Active RN license in applicable state(s).
• Minimum 5 years of nursing experience.
• Minimum 1 year experience in home health, hospice, case management, utilization review, intake, or care coordination.
• Strong clinical assessment and critical thinking skills.
• Knowledge of Medicaid, Medicare, and home health regulations.
• Excellent verbal and written communication skills.
• Experience reviewing medical records and clinical documentation.
• Proficiency with EMR systems and Google Office.

Preferred

• Pediatric home health experience.
• Family caregiver program experience.
• Prior authorization or utilization management experience.
• Bilingual capabilities.

Benefits

• Competitive compensation packages reflecting the value you bring.
• Annual company performance bonus for full-time employees.
• Comprehensive health coverage, including a $0 deductible PPO and a company-funded HSA, alongside employer-paid life and disability insurance.
• Generous paid time off, including 10 paid company holidays.
• Financial savings benefits, such as HSA contributions, optional FSA and commuter benefits, and full coverage of all 401(k) account fees (employer match not currently offered).
• Paid parental leave to support your growing family.

Our Values

• Families First
• Urgency with Precision
• Relentlessly Resourceful
• Purpose with Positivity
• Driven to Redefine What's Possible

Compensation Range

$85K - $105K