Complex Care Manager RN

Site: Mass General Brigham Community Physicians Inc.

Mass 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.

The Opportunity

The Nurse Case Manager is assigned to the Newton/Wellesley/Needham site(s) and serves as a core member of the care team. The Case Manager coordinates and supports healthcare within the facility and coordinates referrals for services outside the clinic. Provides outreach and enrollment services to meet eligibility requirements of the program and surrounding counties. Ensures coordination and planning including community and family support. Focuses on the development and coordination of community service plans. Partners with service providers families and patients to create a plan of healthcare and identify additional service providers.

Job Summary

Primary Responsibilities:

-Modify patient treatment plans as indicated by patients responses and conditions.
-Prepare patient/family for discharge
-Communicates with third party payers to obtain necessary authorization for reimbursement of services.
-Review cases with medical directors on challenging cases as needed
-Defines care goals of patients by providing education information and direction to each individual and family.
-Maintain accurate detailed reports and records.
-Communicates with third party payers to obtain necessary authorization for reimbursement of services.

What Youll Bring

• Associates Degree Nursing or Bachelors Degree Nursing required

• Massachusetts Registered Nurse (RN) License required

• 3 years RN experience required

• Valid Drivers License and reliable transportation required

• Basic Life Support (BLS) Certification preferred

• 2 years case management utilization review or discharge planning experience preferred

Additional Knowledge Skills & Abilities:

• Giving full attention to what other people are saying taking time to understand the points being made asking questions as appropriate and not interrupting at inappropriate times.

• Using logic and reasoning to identify the strengths and weaknesses of alternative solutions conclusions or approaches to problems.

• Ability to establish strong rapport and relationships with patients and staff.

• Proficient in Microsoft Office and industry related software programs.

• Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions.

• Ability to maintain client and staff confidentiality.

• Understanding of diagnostic criteria for dual conditions and the ability to conceptualize modalities and placement criteria within the continuum of care.

• Knowledge of Healthcare and Managed Care preferred.

Schedule and Work Model

• Full-time (40 hours) Monday through Friday standard business hours.

• Location: Newton/Wellesley/Needham

• Hybrid work model. Approximately 2-3 days in the practice and field approximately 2-3 days at home.

• Remote work days require stable secure quiet compliant work station.

Hybrid

1450 Highland Street

40

Regular

Day (United States of America)

Pay Range

$58656.00 - $142448.80/Annual

Grade

98TEMP

At Mass General Brigham we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive and any offer extended will take into account your skills relevant experience if applicable education certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however it does not encompass all elements contributing to your total compensation addition to competitive base pay we offer comprehensive benefits career advancement opportunities differentials premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.

6010 Mass General Brigham Community Physicians Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race color religious creed national origin sex age gender identity disability sexual orientation military service genetic information and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process to perform essential job functions and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973 the Vietnam Veterans Readjustment Act of 1974 and Title I of the Americans with Disabilities Act of 1990 applicants who require accommodation in the job application process may contact Human Resources at .

Mass General Brigham Competency Framework