Complex Case Nurse
About The Position
The Complex Case Nurse supports the Complex Case Unit (CCU) within the Office of MaineCare Services by assisting MaineCare and non‑MaineCare members in resolving complex healthcare, financial, and placement challenges. Through collaboration with providers, community partners, and multidisciplinary teams, the CCU works to deliver timely, coordinated, and sustainable solutions for individuals with high‑needs situations. This role supports Maine residents of all ages with complex, chronic, acute, developmental, or psychosocial needs when community‑based efforts have been exhausted and additional intervention is required.
Requirements
- Three (3) years of progressively responsible professional experience in nursing and/or healthcare service delivery
- Two (2) to three (3) years of clinical pediatric and adult experience or prior case management experience
- Current licensure as a Registered Nurse (RN) in the State of Maine, issued by the Maine State Board of Nursing
Nice To Haves
- Experience working with individuals of all ages diagnosed with physical, developmental, and mental health conditions, particularly those with complex needs
- Knowledge of MaineCare, related State agencies, and statewide community resources
- Ability to build and maintain effective working relationships with: MaineCare members, families, and guardians Healthcare providers (hospitals, home health agencies, private duty nursing agencies, primary care providers, specialists, therapists, and out‑of‑state providers) Provider associations and community partners
- Strong ability to collect, analyze, and interpret case information and make sound, independent decisions
- Ability to work independently while contributing effectively within a multidisciplinary team environment
- Excellent critical thinking, communication, organization, and problem‑solving skills
Responsibilities
- Provide information, problem‑solving assistance, and support to Maine residents, families, guardians, and members of the individual’s support system, including healthcare providers
- Facilitate multidisciplinary team meetings for individuals without a discharge plan until a safe placement is identified or complex issues are resolved
- Coordinate with statewide service delivery resources, both internal and external to DHHS, on complex cases
- Escalate complex or high‑risk cases to middle and senior management as appropriate
- Maintain collaborative relationships with community agencies, hospitals, providers, and DHHS program areas, including: Office of Behavioral Health Adult Protective Services Children’s Protective Services Office of Child and Family Services Brain Injury Services Developmental Disability Services
- Educate providers, members, and families while ensuring a professional and objective approach focused on optimal member outcomes
Benefits
- Health, vision, and dental insurance
- 401(k) with discretionary employer match
- Paid time off and holidays
- Flexible spending accounts
- Additional employee perks
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
