Complex Care Manager RN

Mass General Brigham • Needham, MA

1d • $58,656 - $142,449 • Hybrid

About The Position

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

Requirements

• Associate's Degree Nursing or Bachelor's Degree Nursing required
• Massachusetts Registered Nurse (RN) License required
• 3+ years RN experience required
• Valid Driver's License and reliable transportation required
• 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.

Nice To Haves

• Basic Life Support (BLS) Certification preferred
• 2+ years case management, utilization review, or discharge planning experience preferred
• Knowledge of Healthcare and Managed Care preferred.

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 This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree