Hybrid RN Case Manager: Care Coordination

Partner's Healthcare; Somerville (MA); Hybrid; USD 59,000 - 142,000; Full time

Job summary

Mass General Brigham Community Physicians, Inc. seeks a Registered Nurse Case Manager to coordinate healthcare services within the facility and manage referrals outside the clinic. The role includes outreach for program eligibility and developing community service plans with families and service providers.

The RN will support discharge planning, coordinate with payers for authorizations, and ensure comprehensive patient education and care coordination across the continuum.

Qualifications

• Associate's Degree in Nursing required; Bachelor’s Degree in Nursing preferred.
• Active and unrestricted RN licensure in Massachusetts required.
• 2+ years of case management and/or discharge planning experience.
• Experience working with complex dually eligible populations required.
• Knowledge of Managed Care preferred.
• Understanding of diagnostic criteria for dual conditions and placement criteria within the continuum of care 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 necessary authorization for reimbursement of services.
• Define care goals for patients 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

Case management

Discharge planning

Communication with payers

Patient coordination

Microsoft Office

Education

Associate's Degree in Nursing

Bachelor's Degree in Nursing (preferred)

Tools

Microsoft Office

Job description

Mass General Brigham Community Physicians, Inc. seeks a Registered Nurse Case Manager to coordinate healthcare services within the facility and manage referrals outside the clinic. The role includes outreach for program eligibility and developing community service plans with families and service providers.

The RN will support discharge planning, coordinate with payers for authorizations, and ensure comprehensive patient education and care coordination across the continuum.