Hybrid RN Triage and Case Manager for IHCS/PCA

Fallon Health; Massachusetts; Hybrid; USD 95,000 - 100,000; Full time

Job summary

Fallon Health in Worcester, MA is seeking a Triage Case Manager to provide clinical triage, case consultation, and program oversight for IHCS and PCA services. This role combines nursing expertise with program management in a hybrid work model.

The position requires an active MA RN license, 3+ years of complex RN experience, and ability to work across interdisciplinary teams, with certification in Case Management preferred and driving required. Competitive pay and benefits offered.

Qualifications

• RN with MA nursing license required.
• 3+ years of clinical RN experience with complex cases.
• Willingness to obtain Case Management certification; driving required.

Responsibilities

• Serve as primary clinical liaison for IHCS and PCA programs.
• Triage referrals and coordinate interdisciplinary case consultations for complex members.
• Provide program oversight for IHCS and PCA services and regulatory compliance.
• Collaborate with LTSS, Utilization Management, and Medical Directors on complex cases.
• Lead quality improvement initiatives and readiness activities for regulatory audits.

Skills

Communication skills

Interdisciplinary teamwork

Problem-solving

Assessments (in-person & telehealth)

Education

Registered Nurse (RN) - MA license

Bachelor's degree preferred

Job description

Fallon Health in Worcester, MA is seeking a Triage Case Manager to provide clinical triage, case consultation, and program oversight for IHCS and PCA services. This role combines nursing expertise with program management in a hybrid work model.

The position requires an active MA RN license, 3+ years of complex RN experience, and ability to work across interdisciplinary teams, with certification in Case Management preferred and driving required. Competitive pay and benefits offered.