Fallon Health

Homecare RN Coordinator- Assessment work - No hands on -Growing Elder Service program - Amherst NY

Location US-NY-Amherst, NY
Posted Date 1 month ago(4/24/2020 4:01 PM)
Job ID
# Positions


Fallon Health Weinberg is a partnership between Fallon Health of Massachusetts and Weinberg Campus of Erie County, New York. Fallon Health Weinberg offers a Program of All-Inclusive Care for the Elderly (PACE) and a Managed Long Term Care (MLTC) plan to serve the health needs of dual-eligible residents of the Western New York counties of Erie and Niagara. Fallon Health Weinberg expands the choices that residents of Erie and Niagara Counties have when it comes to high-quality, affordable health care.

Founded in 1977, Fallon Health provides health care services designed to meet the unique and changing needs of all they serve. It consistently ranks as one of the nation's highest-rated health plans, according to the National Committee for Quality Assurance (NCQA).* Fallon Health coordinates care with its Senior Care Options/Special Needs Plan for dual-eligible people who are 65 and older. Fallon Health has operated a PACE program in Massachusetts for more than 20 years and is the largest PACE program in New England and sixth largest nationally.**


About Fallon Health Weinberg-PACE: Fallon Health Weinberg-PACE is a long-term care

program for older adults who qualify for a nursing-home level of care, but wish to stay living at

home and in their community. We are a Program of All-inclusive Care for the Elderly (PACE),

providing complete medical care and support services that helps people to remain living safely at

home. All care is coordinated and provided by an interdisciplinary team specializing in geriatric

care, working with participants and their caregivers to create an individualized care plan.


As part of the PACE interdisciplinary team, responsible for the coordination and monitoring of care and services to maintain participants in a safe community environment. 


  • Review and implements physician’s orders.
  • Conducts comprehensive nursing assessments including physical, psychosocial, behavioral, and environmental.
  • Educates and involves participants and significant other(s) in the plan of care in a manner appropriate for those involved. Interacts with participants and significant others in a culturally sensitive manner. Recommends care and services that are culturally appropriate.
  • Monitors and evaluates therapeutic interventions.
  • Participates in the development and ongoing review of each participant’s care plan.
  • Coordinates participants’ care responsibilities to other members of the health care team, as appropriate.
  • Identifies emergency situations and initiates appropriate nursing interventions and follow-up.
  • Meets the needs of participants in a timely manner.
  • Participates in the interdisciplinary team (IDT) process and collaborates with IDT members to identify care and services to maintain the participant safe in the community.
  • Documents activates related to participant care, including significant changes in health status, monthly nurses’ notes, and health teaching in the medical record.
  • Participates in training and orientation of new nursing staff as assigned.
  • Assists in the delivery of other nursing services as assigned.
  • Participates in the nursing “on-call” rotation as assigned.

Performs all duties in accordance with Fallon Health Weinberg policies and procedures.


  • Graduate of an accredited school of nursing
  • Current license as an RN in the state of New York
  • CPR certification, or willingness to be certified within 60 days of hire, is essential
  • At least two years of recent experience in the direct care of adults or chronically disabled persons with at least one year caring for a frail or elderly population. Ambulatory care or home care experience helpful.




Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.








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