MA - Intake Nurse

About 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 closely with referral sources, family growth associates, case managers, business development teams, and clinical leadership to evaluate referrals, assess patient needs, determine service appropriateness, and support timely admissions. The Intake RN uses clinical judgment to identify patients who qualify for skilled nursing, home health aide, personal care, paid family caregiver, or other agency services while ensuring compliance with state regulations, payer requirements, and agency policies. This role reports directly to the Director of Nursing for the agency.

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.
• Assess 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.
• Verify functional limitations, care needs, diagnosis history, medication management needs, and caregiver support systems.
• 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.
• Assist with prior authorization clinical documentation as needed.
• Admission Coordination
• Collaborate with scheduling and operations teams to coordinate Start of Care (SOC) visits.
• Work with FGAs 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

Additional Information

About Abby Care: Powering the future of care at home for all of America. Abby Care is building the leading AI-native platform for family-led care. America is facing a growing care crisis. Millions more people need care at home than ever. Over 50 million family caregivers support loved ones without the tools, training, or recognition they deserve. We believe families are the largest untapped caregiving workforce in America, and that technology can help them deliver better care while driving stronger outcomes and greater transparency across the healthcare system. Abby Care combines clinical oversight with an AI-powered platform to train, enable, and support family caregivers in delivering high-quality care at home. Our platform helps health plans and government partners better understand, verify, and improve care in the home. We expand access to care, reduce reliance on higher-cost settings, and help ensure public dollars are spent effectively. We are proud to partner with leading health plans, providers, and community organizations and are backed by top VCs. We envision a future where family-led care is a core part of the healthcare system. Abby Care is building that future. Join us in solving one of the most important challenges of our time.

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