BFT RN CARE COORDINATOR

Mass General Brigham

Somerville (MA)

On-site

USD 101,780,000 - 197,360,000

Full time

14 days+

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Job summary

Mass General Brigham is seeking a Registered Nurse Care Coordinator to support community health programs, patient navigation, and care coordination across multiple community-based initiatives. The role emphasizes hypertension management, preventive care, and collaboration with CHI Specialists and primary care teams.

The position involves outreach via phone and virtual platforms, referral coordination, and documentation in EMR, reporting to the Senior Medical Director of Clinical Community

Qualifications

  • Current Massachusetts RN licensure required.
  • BSN preferred.
  • Minimum of 3–5 years nursing, care coordination, population health, or community health experience preferred.
  • Experience in community-based settings preferred.
  • Experience supporting chronic disease management and preventive health initiatives preferred.

Responsibilities

  • Coordinate care for patients across community-based programs.
  • Assist with patient outreach, care coordination, and referral management.
  • Support quality improvement initiatives and performance management.
  • Document patient interactions and interventions in the EMR.
  • Collaborate with CHI Specialists, clinicians, and community partners.

Skills

Care coordination
Patient engagement
Effective communication
EMR proficiency
Remote collaboration

Education

BSN preferred

Tools

Electronic Medical Records
Virtual platforms

Job description

Site: The General Hospital Corporation

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

Bulfinch Temporary Service is hiring for a Care Coordinator to work on the Community Care vans! Please note that this position is temporary in nature but is long term. There are no benefits associated with this role. It is M-F 8:30-5pm.

Qualifications

Mass General Brigham (MGB) Community Health is committed to improving health outcomes for all. The Clinical-Community Programs team in the Office of the Chief Medical Officer develops and implements innovative, community-based models of care that improve access to preventive services, strengthen care coordination, and address the social and clinical factors that influence health outcomes. This portfolio includes the Community Health Improvement (CHI) Corps, the MGB Community Care Vans and other community-based clinical initiatives designed to improve health of the populations we serve.

The Care Coordinator RN is a key member of the Clinical Community Programs team and will work collaboratively with the Senior Medical Director of Clinical Community Programs, physicians, advanced practice providers, CHI Specialists, primary care teams, and community partners to coordinate care for patients across community-based programs. The role supports clinical operations, patient navigation, care coordination, referral management, quality improvement initiatives, and performance management that enhance access to care and improve health outcomes.

A primary responsibility of this position is supporting the Community Health Improvement (CHI) Corps and Community Care Vans, with a particular focus on initiatives related to hypertension (HTN) management, colorectal cancer (CRC) screening, and other preventive health priorities. The RN will also provide clinical care coordination and operational support across additional Clinical Community Programs as organizational needs evolve.

The RN Care Coordinator will assist with patient outreach, care coordination, referral management, follow-up activities, and interdisciplinary communication across multiple neighborhoods and clinical programs. This role requires a strong understanding of community health, culturally responsive communication, care coordination strategies, and the ability to work effectively across both clinical and community settings.

This position reports directly to the Senior Medical Director of Clinical Community Programs.

Additional Job Details (if applicable)

  • Collaborate closely with CHI Specialists and Community Care Van teams to support care coordination across designated priority neighborhoods.
  • Collaborate closely with the Senior Medical Director of Clinical Community Programs on clinical questions, case review, protocol development, and care coordination strategies.
  • Serve as a clinical resource to Community Health Improvement (CHI) Specialists and other program staff by providing guidance on clinical workflows, patient navigation, and appropriate escalation of clinical concerns.
  • Conduct remote patient outreach via phone and virtual platforms to support improved health outcomes, preventive care initiatives, and continuity of care.
  • Coordinate follow-up care for patients identified through community outreach, screenings, and Clinical Community Program initiatives.
  • Facilitate referrals and warm handoffs between patients, primary care providers, specialists, community-based organizations, and other internal and external resources.
  • Provide culturally responsive patient education related to hypertension prevention and management, colorectal cancer screening, chronic disease management, preventive care, and wellness.
  • Support clinical care coordination across Clinical Community Programs, including participation in new program implementation and workflow development as organizational priorities evolve.
  • Review patient registries, identify care gaps, and assist with outreach strategies to improve quality metrics and patient outcomes.
  • Support initiatives aimed at improving health outcomes across underserved communities through evidence-based, community-centered care coordination.
  • Document patient interactions, care coordination activities, and interventions accurately within the electronic medical record and other designated systems.
  • Support data tracking, documentation, reporting, and analysis related to patient outreach, clinical outcomes, and program performance.
  • Participate in interdisciplinary meetings, case conferences, and quality improvement initiatives to optimize patient care and operational workflows.
  • Support program performance management by monitoring key performance indicators, identifying opportunities for improvement, and collaborating with interdisciplinary team members to enhance program quality, operational efficiency, and patient outcomes.
  • Support quality assurance activities by promoting adherence to program standards, clinical workflows, documentation requirements, evidence-based practices, and organizational policies while identifying opportunities for continuous quality improvement.
  • Maintain patient confidentiality and comply with all organizational privacy, regulatory, and compliance standards.
  • Stay current on best practices in care coordination, population health, and community-based nursing to support continuous program improvement.
  • Perform other duties as assigned in support of the Clinical Community Programs portfolio.
Qualifications -
  • Current Massachusetts Registered Nurse (RN) licensure required.
  • Bachelor of Science in Nursing (BSN) preferred.
  • Minimum of 3-5years of nursing, care coordination, population health, or community health experience preferred.
  • Experience working in community-based settings strongly preferred.
  • Experience supporting chronic disease management and preventive health initiatives preferred.
Skills
  • Strong care coordination and patient engagement skills.
  • Ability to communicate effectively with patients, providers, and community partners.
  • Knowledge of chronic disease prevention and preventive health strategies preferred.
  • Ability to work independently in a remote work environment while maintaining strong collaboration with interdisciplinary teams.
  • Strong organizational skills and attention to detail.
  • Ability to manage multiple priorities and adapt to changing program needs.
  • Demonstrated commitment to health equity and culturally responsive care.
  • Proficiency with electronic medical records and virtual communication platforms.
  • Ability to maintain confidentiality and comply with all local, state, and federal privacy regulations.

Remote Type

Onsite

Work Location

399 Revolution Drive

Scheduled Weekly Hours

0

Employee Type

Temporary

Work Shift

Day (United States of America)

Pay Range

$35.52 - $68.83/Hourly

Grade

6NTEMP

At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth.

EEO Statement:

1200 The General Hospital Corporation is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.

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.

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