Complex Care Nurse (RN) Care Manager

The General Hospital Corporation; Boston (MA); Hybrid; USD 5,900 - 142,000; Full time

Benefits offered by this job

Hybrid work model

Job summary

Mass General Brigham Community Physicians, Inc. is seeking a dedicated RN Case Manager to coordinate patient care plans, support discharge processes, and ensure accurate documentation.

The role involves collaboration with physicians, families, and payers to secure appropriate authorizations and resources. The position requires 2+ years of case management experience, an MA RN license, and nursing degrees (Associates required, Bachelors preferred).

Qualifications

• Associate's Degree in Nursing is required.
• RN License in Massachusetts is required.
• 2+ years of case management, utilization review, or discharge planning experience is required.
• Bachelor's degree is preferred.
• Proficiency in Microsoft Office and related software is expected.

Responsibilities

• Client assessments and care planning.
• Modify patient treatment plans as needed.
• Prepare patient/family for discharge.
• Coordinate with third-party payers for reimbursement authorization.
• Review challenging cases with medical directors as needed.
• Define care goals and provide education and direction to patients and families.
• Maintain accurate, detailed reports and records.

Skills

Communication skills

Empathy

Active listening

Confidentiality

Analytical thinking

Education

Associate's Degree in Nursing

Bachelor's Degree in Nursing

RN License (MA)

Tools

Microsoft Office

Industry software

Job description

Site: Mass General Brigham Community Physicians, Inc.

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.

Essential Functions

• 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.

Qualifications

Education

• Associate's Degree Nursing required.
• Bachelor's Degree Nursing preferred.

Licenses and Credentials

• Registered Nurse (RN) License for the State of Massachusetts required.

Experience

• 2+ years of case management, utilization review, or discharge planning experience required.

Additional Knowledge, Skills and 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 Monday through Friday 8am-4:30pm or 8:30am-5pm
• Hybrid work model (approximately 1-2 days in clinic in Jamaica Plain; approximately 2-3 days in the field; approximately 1 day at home)
• On remote workdays, employees must use a stable, secure, and compliant workstation in a quiet environment. Teams video is required and must be accessed using MGB-provided equipment.

Work Location

301 South Huntington Street

Scheduled Weekly Hours

40

Employee Type

Regular

Work Shift

Day (United States of America)

Pay Range

$58,656.00 - $142,448.80/Annual

Grade

98TEMP

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

6010 Mass General Brigham Community Physicians, Inc. 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 part