RN Case Manager - Nantucket

Mass General Brigham•Nantucket, MA

16d•$58,656 - $142,449•Hybrid

About The Position

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.

Requirements

MA RN license required
Proficient in Microsoft Office and industry related software programs.
Ability to maintain client and staff confidentiality.

Nice To Haves

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

Responsibilities

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.