MaineCare Complex Case RN

State of Maine•Augusta, GA

About The Position

The Complex Case Nurse works in the Complex Case Unit (CCU) of the Office of MaineCare Services within Maine’s Department of Health and Human Services. The role uses clinical expertise to support Maine residents of all ages with complex medical, developmental, behavioral, or psychosocial needs. The nurse collaborates with individuals, families, providers, and state agencies to assess needs, coordinate multidisciplinary team meetings, and develop a path toward resolution. The work helps people navigate complex systems and access appropriate care and services. The CCU works with MaineCare members and other Maine residents to address complex healthcare, financial, and placement challenges. It brings together providers, community partners, and state agencies to coordinate care, address barriers, and develop solutions when usual resources and services have not resolved an individual's needs. This position reports to the Complex Case Manager. The position is located in Augusta, Maine. It is not eligible for visa sponsorship or STEM OPT extensions.

Requirements

Registered Nurse with three years of progressively responsible experience in nursing and/or the delivery of health care services.
Licensed as a Registered Professional Nurse in the State of Maine, as issued by the State Board of Nursing.
Address the listed competencies in the cover letter: knowledge of and experience with people of all ages who have complex medical, physical, developmental, behavioral, or mental health needs; familiarity with MaineCare, state agencies, and statewide community resources; ability to establish and maintain effective, objective, and professional working relationships; ability to gather and analyze case information, assess complex situations, identify barriers, draw sound conclusions, and make informed decisions independently; ability to work independently and within multidisciplinary teams to coordinate services and develop practical solutions; and strong critical-thinking, problem-solving, communication, organizational, and time-management skills, including managing competing priorities and recognizing when escalation is needed.

Nice To Haves

Two to three years of clinical pediatric and adult experience, or previous case management experience.
Experience with and knowledge of the Medicaid program and/or other health and human services programs serving low-income populations.
Lived experience with Medicaid and/or other health-related social needs common to individuals and families receiving Medicaid coverage.

Responsibilities

Provide information, problem-solving assistance, and support to Maine residents, their families, support networks, and healthcare providers.
Facilitate multidisciplinary team meetings for individuals who lack a discharge plan or face other complex challenges; work with involved parties to identify safe placement options and resolve barriers to care.
Coordinate with statewide service providers, community resources, and internal and external DHHS partners to address complex cases and identify solutions.
Escalate complex cases to middle and senior management and consult with leadership as needed.
Build and maintain collaborative relationships with community agencies, hospitals, healthcare providers, MaineCare members, families, and DHHS offices and programs.

Benefits

13 paid holidays and more than three weeks of vacation leave annually; vacation accrual increases with years of service, and overtime-exempt employees receive personal leave.
12 days of sick leave per year.
The State pays 85%–95% of employee-only health insurance premiums, depending on salary; dependent coverage is also available.
A 5% employee-only health insurance premium credit for participation in the applicable program.
The State pays 100% of employee-only dental insurance premiums.
MainePERS retirement contribution equivalent to 14.06% of employee pay.
Gym membership reimbursement of up to $40 per month.
Health and dependent care flexible spending accounts.
Eligibility for Public Service Student Loan Forgiveness through the State's status as a qualified employer.
Living Resources employee assistance program.
Six weeks of fully paid parental leave for employees welcoming a child, including non-birthing and adoptive parents; additional unpaid leave may be available under the Family and Medical Leave Act.
Voluntary pre-tax retirement savings through a MaineSaves 457(b) account.
Additional wellness benefits; benefits may vary by collective bargaining agreement and are prorated for less than full-time work.