Nurse Case Manager

1550 Martha's Vineyard Hospital, Inc.; Eastville (MA); On-site; USD 59,000 - 142,000; Full time

Job summary

Martha’s Vineyard Hospital, Inc. is seeking a skilled nurse to coordinate care within the facility, coordinate referrals, and provide outreach and enrollment services to meet program eligibility.

You will partner with families, patients, and service providers to craft comprehensive care plans and support transitions across the continuum of care. Ideal candidates bring 2–3 years in case management, utilization review, or discharge planning, with RN licensure in the state and BLS certification.

Qualifications

• RN license required (state).
• Associate's Degree in Nursing required; Bachelor's degree preferred.
• BLS certification preferred.

Responsibilities

• 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.

Skills

Registered Nurse (RN) license

BLS Certification

Case management

Utilization review

Discharge planning

Education

Associate's Degree in Nursing

Bachelor's Degree in Nursing

Tools

Microsoft Office

Job description

Site: Martha’s Vineyard Hospital, 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. 24 hour hours per week; weekend and holiday ; 2 days on site

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. Does this position require Patient Care?Yes

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 or Bachelor's Degree Nursing preferred. Can this role accept experience in lieu of a degree? No.

• Registered Nurse [RN - State License] - Generic - HR Only required
• Basic Life Support [BLS Certification] - Data Conversion - Various Issuers preferred

Experience Case management, utilization review, or discharge planning experience 2-3 years preferred

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.

Physical Requirements

• Standing Frequently (34-66%)
• Walking Frequently (34-66%)
• Sitting Occasionally (3-33%)
• Lifting Frequently (34-66%) 35lbs+ (w/assisted device)
• Carrying Frequently (34-66%) 20lbs - 35lbs
• Pushing Occasionally (3-33%)
• Pulling Occasionally (3-33%)
• Climbing Rarely (Less than 2%)
• Balancing Frequently (34-66%)
• Stooping Occasionally (3-33%)
• Kneeling Occasionally (3-33%)
• Crouching Occasionally (3-33%)
• Crawling Rarely (Less than 2%)
• Reaching Frequently (34-66%)
• Gross Manipulation (Handling) Frequently (34-66%)
• Fine Manipulation (Fingering) Frequently (34-66%)
• Feeling Constantly (67-100%)
• Foot Use Rarely (Less than 2%)
• Vision - Far Constantly (67-100%)
• Vision - Near Constantly (67-100%)
• Talking Constantly (67-100%)
• Hearing Constantly (67-100%)

Remote Type Remote Work Location One Hospital Road Scheduled Weekly Hours 24 Employee Type Regular Work Shift Day (United States of America) Pay Range $58,656.00 - $142,448.80/Annual Grade 98TEMP

EEO Statement: Martha's Vineyard Hospital, 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 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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Mass General Brigham is a passionate, welcoming community where minds meet caring hearts. Come be a part of the world’s most powerful force in medicine, where every role is important in changing lives. Are you ready? Our history includes New England hospitals founded over 200 years ago, some of the first and most prestigious hospitals in the world. Built on the legacy of two leading academic medical centers, we’re more than a system—we’re leaders in the practice of medicine. Mass General Brigham is committed to serving the community. We are dedicated to enhancing patient care, teaching and research, and taking a leadership role as an integrated health care system. We recognize that increasing value and continuously improving quality are essential to maintaining excellence.