Hybrid RN Case Manager - Care Coordination

Mass General Brigham Community Physicians; Somerville (MA); Hybrid; USD 85,000 - 115,000; Full time

Job summary

Mass General Brigham Community Physicians, Inc. is seeking an RN Case Manager to coordinate and support care within the facility and manage referrals for services outside the clinic.

You will provide outreach and enrollment assistance to meet program eligibility and work with families and service providers to develop comprehensive care plans. The role requires an RN license in Massachusetts, 2+ years in case management or discharge planning, and strong communication skills.

Qualifications

• Associate's degree in Nursing is required (Bachelor's degree preferred).
• Active and unrestricted RN licensure for Massachusetts required.
• 2+ years of case management and/or discharge planning required.
• Experience with complex dually eligible populations required.
• Knowledge of Managed Care preferred.
• Understanding of diagnostic criteria for dual conditions and placement within continuum of care preferred.
• Utilization Review experience preferred.

Responsibilities

• Conduct client assessments and planning.
• Modify patient treatment plans as indicated by patients' responses and conditions.
• Prepare patient/family for discharge.
• Communicate with third party payers to obtain authorization for reimbursement of services.
• Define care goals by providing education, information, and direction to each individual and family.
• Review cases with medical directors on challenging cases as needed.
• Maintain accurate, detailed reports and records.

Skills

Empathy

Communication

Rapport building

Confidentiality

Microsoft Office

Industry software

Education

Associate's Degree in Nursing

Bachelor's Degree in Nursing preferred

Tools

Microsoft Office

Job description

Mass General Brigham Community Physicians, Inc. is seeking an RN Case Manager to coordinate and support care within the facility and manage referrals for services outside the clinic.

You will provide outreach and enrollment assistance to meet program eligibility and work with families and service providers to develop comprehensive care plans. The role requires an RN license in Massachusetts, 2+ years in case management or discharge planning, and strong communication skills.