Employer Active
Job Alert
You will be updated with latest job alerts via emailJob Alert
You will be updated with latest job alerts via emailMass General Brigham relies on a wide range of professionals including doctors nurses business people tech experts researchers and systems analysts to advance our mission. As a not-for-profit we support patient care research teaching and community service striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.
Job Summary
Aspire is a program of Mass General Brigham that serves teens and young adults with social cognition challenges including Aspergers Syndrome High-Cognitive Autism Nonverbal Learning Disorder and autism spectrum disorder that focuses on helping teens develop increased self-awareness social competency and stress management skills.Qualifications
Responsible for coordinating the transfer of patients between different levels of care such as from the hospital to a skilled
nursing facility home health agency or outpatient care by working collaboratively with healthcare teams patients families and external
providers to ensure the continuity of care and facilitate successful transitions.
Collaborate with the healthcare team to develop comprehensive care transition plans for patients taking into account their medical social and emotional needs.
Conduct thorough assessments of patients physical psychological and social conditions to determine the most appropriate post-discharge
care setting.
Work closely with healthcare providers to plan and coordinate the timely and safe discharge of patients ensuring that necessary services
and resources are in place.
Identify and connect patients with appropriate community resources home health services durable medical equipment and other support
services to facilitate a smooth transition from hospital to post-acute care.
Provide patients and their families with education about their medical conditions medications self-care techniques and follow-up care
instructions to promote better health outcomes after discharge.
Document all care coordination activities assessments and interventions accurately in the patients electronic health record (EHR) to
ensure continuity of care and compliance with regulatory requirements.
Advocate for patients needs during the discharge process ensuring that they have access to appropriate care and support services upon
leaving the hospital.
Education: bachelors degree Nursing required
Nursing Experience: 2-3 years required and Care Coordination/Case Management Experience 1-2 years preferred
Knowledge Skills and Abilities:
Familiarity with healthcare systems post-acute care services and community resources that support care transitions.
Understanding of healthcare regulations and guidelines related to care coordination.
Excellent communication and interpersonal skills to effectively interact with patients families healthcare teams and external providers.
Strong critical thinking and problem-solving abilities to assess complex patient situations and develop appropriate care plans.
Ability to prioritize tasks and manage time effectively in a fast-paced hospital environment.
Additional Job Details (if applicable)
Physical Requirements
Remote Type
Work Location
Scheduled Weekly Hours
Employee Type
Work Shift
Pay Range
$17.36 - $23.80/HourlyGrade
2EEO Statement:
At Mass General Brigham our competency framework defines what effective leadership looks like by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance make hiring decisions identify development needs mobilize employees across our system and establish a strong talent pipeline.
Required Experience:
Staff IC
Part-Time