Nurse Case Manager

Mass General Brigham•East Sandwich, MA

1d•Onsite

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. Job Summary Serves as a core member of the care team 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. Does this position require Patient Care? Yes -Client Assessments and Planning -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.

Requirements

Associate's Degree Nursing required or Bachelor's Degree Nursing preferred
Can this role accept experience in lieu of a degree? No
Registered Nurse [RN - Massachusetts License] - required
Case management, utilization review, or discharge planning experience 2-3 years preferred
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.

Nice To Haves

Bachelor's Degree Nursing preferred
Basic Life Support [BLS Certification] - preferred
Case management, utilization review, or discharge planning experience 2-3 years preferred
Knowledge of Healthcare and Managed Care preferred.

Responsibilities

Serves as a core member of the care team 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.
Client Assessments and Planning
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.