Complex Care Nurse (RN) Care Manager

Mass General Brigham•Boston, MA

3d•$58,656 - $142,449•Hybrid

About The Position

Serves as a core member of the care team, coordinating and supporting healthcare within the facility and coordinating referrals for services outside the clinic. Provides outreach and enrollment services to meet program eligibility requirements in surrounding counties. Coordinates care planning, including community and family support, and focuses on developing and coordinating community service plans. Partners with service providers, families, and patients to create healthcare plans and identify additional service providers. This is a full-time, hybrid role with a Monday-through-Friday schedule of either 8:00 a.m.–4:30 p.m. or 8:30 a.m.–5:00 p.m. The work model includes approximately 1–2 days in the Jamaica Plain clinic, 2–3 days in the field, and 1 day at home. Remote work requires a stable, secure, compliant workstation in a quiet environment; Teams video must be accessed using MGB-provided equipment.

Requirements

Associate’s degree in Nursing.
Registered Nurse (RN) license for the State of Massachusetts.
At least 2 years of case management, utilization review, or discharge planning experience.
Ability to listen attentively, understand others’ points, ask appropriate questions, and avoid interrupting at inappropriate times.
Ability to use logic and reasoning to assess alternative solutions, conclusions, or approaches to problems.
Ability to establish strong rapport and relationships with patients and staff.
Proficiency in Microsoft Office and industry-related software programs.
Ability to identify complex problems, evaluate options, and implement solutions.
Ability to maintain client and staff confidentiality.
Understanding of diagnostic criteria for dual conditions and ability to conceptualize modalities and placement criteria within the continuum of care.

Nice To Haves

Bachelor’s degree in Nursing.
Knowledge of healthcare and managed care.

Responsibilities

Assess clients and develop care plans.
Modify patient treatment plans in response to patients’ conditions and responses.
Prepare patients and families for discharge.
Communicate with third-party payers to obtain authorization for reimbursement of services.
Review challenging cases with medical directors as needed.
Define patient care goals by providing education, information, and direction to individuals and families.
Maintain accurate, detailed reports and records.
Coordinate healthcare within the facility and referrals to services outside the clinic.
Provide outreach and enrollment services to meet program eligibility requirements.
Coordinate community and family support and develop community service plans.
Partner with service providers, families, and patients to create healthcare plans and identify additional service providers.