Summary
About this role
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.
The Nurse Case Manager is assigned to the Newton/Wellesley/Needham site(s) and serves as a core member of the care team. The Case Manager 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.
Job Summary
Primary Responsibilities:-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.
Qualifications
What You'll Bring
Associate's Degree Nursing or Bachelor's Degree Nursing required
Massachusetts Registered Nurse (RN) License required
3+ years RN experience required
Valid Driver's License and reliable transportation required
Basic Life Support (BLS) Certification preferred
2+ years case management, utilization review, or discharge planning experience preferred
Additional Knowledge, Skills & Abilities:
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.
Knowledge of Healthcare and Managed Care preferred.
Additional Job Details (if applicable)
Schedule and Work Model
Full-time (40 hours) Monday through Friday, standard business hours.
Location: Newton/Wellesley/Needham
Hybrid work model. Approximately 2-3 days in the practice and field, approximately 2-3 days at home.
Remote work days require stable, secure, quiet, compliant work station.
Remote Type
Work Location
Scheduled Weekly Hours
Employee Type
Work Shift
Pay Range
$58,656.00 - $142,448.80/Annual
Grade
98TEMP
EEO Statement:
Mass General Brigham Competency Framework
At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.
Other facts
About Mass General Brigham
Mass General Brigham is an integrated academic health care system, uniting great minds to solve the hardest problems in medicine for our communities and the world. Mass General Brigham connects a full continuum of care across a system of academic medical centers, community and specialty hospitals, a health insurance plan, physician networks, community health centers, home care, and long-term care services. Mass General Brigham is a nonprofit organization that is committed to patient care, research, teaching, and service to the community. In addition, Mass General Brigham is one of the nation’s leading biomedical research organizations and a principal teaching affiliate of Harvard Medical School.
What you'll do
- The Complex Care Manager RN coordinates and supports healthcare within the facility and manages referrals for services outside the clinic. They also develop community service plans and partner with service providers, families, and patients to create healthcare plans.
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