Cityblock Health

RN Assessment Nurse - Barnstable County - Hybrid

Cityblock Health$95K — $104K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Graduate of an accredited school of nursing (R.N.)
  • Minimum of 3 years of experience in nursing
  • Strong critical thinker with the ability to make complex decisions independently
  • Demonstrated problem-solving skills with an ability to identify barriers to care
  • Excellent communication skills, both written and verbal, across multiple mediums

Responsibilities

  • Explain Cityblock's care model to members, ensuring they grasp available services.
  • Complete MDS and comprehensive assessments during intake.
  • Conduct behavioral health assessments and relevant condition screeners.
  • Triage members for behavioral health programming and perform in-person exams as necessary.
  • Collaborate with the care team to determine appropriate member program placement.
  • Develop initial care plans that document clinical concerns, even if declined by the member.
  • Focus on medication reconciliation and educate members on adherence issues.
  • Ensure proper documentation and coding for quality gap closure and risk stratification.

Benefits

  • Health insurance
  • Life insurance
  • Retirement benefits
  • Participation in the company's equity program
  • Paid time off, including vacation and sick leave
Full Job Description
Job Description:

The Assessment RN completes MDS and relevant screenings within assigned territory as scheduled to capture members' clinical needs and meet regulatory requirements, and also works with members to create a comprehensive care plan that accurately reflects members' needs and healthcare goals. Uses clinical judgment to escalate members with urgent clinical needs to appropriate departments as needed.

Responsibilities
  • Explain Cityblock's model of care to members, ensuring they understand the services available to them.
  • Complete the Minimum Data Set (MDS) and/or comprehensive member assessments during the intake process.
  • Conduct self efficacy and relevant condition specific screeners, including behavioral health assessments like PHQ9, GAD7, AUDIT, and DAST10.
  • Triage members requiring behavioral health programming and conduct in person clinical exams when appropriate.
  • Collaborate with the care team to assess if a member requires placement in a different program, whether a lower or higher intensity option is necessary.
  • Develop an initial care plan with the member, clearly documenting any clinical concerns identified during the assessment that the member has declined to include.
  • Focus on medication reconciliation during clinical visits, addressing adherence concerns and educating the member.
  • Address contracted and company prioritized quality gaps, ensuring proper chart documentation and inclusion of necessary codes (ICD or CPT) for gap closure and risk stratification.
  • Use care facilitation, electronic health records, and scheduling platforms to:
  • Collect data
  • Document member interactions
  • Organize information
  • Track tasks
  • Communicate effectively with the team, members, and community resources.


Work Experience
  • Education: Graduate of an accredited school of nursing (R.N.)
  • Experience: 3+ Years of experience
  • Problem Solving: Strong critical thinker with sound clinical judgment who makes complex decisions independently and knows when to collaborate. Identifies system barriers to care and develops creative, practical solutions. Demonstrates a growth mindset and openness to innovative approaches to improve outcomes.
  • Communication: Strong written and verbal communicator across phone, text, virtual, and in-person settings. Comfortable using technology to engage members remotely. Applies Motivational Interviewing and Trauma-Informed Care principles to build trust. Effectively translates clinical information for non-clinical audiences and actively listens to understand and address needs.


We take into account an individual's qualifications, skillset, and experience in determining final salary. This role is eligible for health insurance, life insurance, retirement benefits, participation in the company's equity program, paid time off, including vacation and sick leave. The actual offer will be at the company's sole discretion and determined by relevant business considerations, including the final candidate's qualifications, years of experience, skillset, and geographic location. The expected salary range for this position is:
$95,000 - $104,000

About Cityblock Health

Cityblock Health is a healthcare provider that offers primary care, behavioral health, and social services to low-income communities. The company was founded in 2017 by Iyah Romm, Bay Gross, and Toyin Ajayi. Cityblock Health aims to provide affordable and accessible healthcare to underserved populations by leveraging technology and community partnerships. The company has raised over $500 million in funding and has partnerships with major healthcare providers such as EmblemHealth and Blue Cross Blue Shield. Cityblock Health is headquartered in Brooklyn, New York.
Learn more about Cityblock Health
Size
1,000 employees
Industry
Founded
2017

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