Remote Nurse Case Manager: LTSS & Care Coordination

University of Massachusetts Medical School; Westborough (MA); Remote; USD 75,000 - 105,000; Full time

Job summary

University of Massachusetts Medical School seeks a Nurse Reviewer II to provide administrative case management for the Community Case Management Program. You will coordinate long-term services, assess care needs, and collaborate with nursing providers, state agencies, hospitals, and programs to ensure continuity of care.

The role requires MA RN licensure, 5–7 years of experience with pediatric to medically complex populations, and statewide travel.

Qualifications

• Active RN license in Massachusetts.
• 5–7 years of work experience with at least 3 years direct service or case management for pediatric to medically complex populations.
• Ability to travel statewide to member homes and provider locations.
• Experience with Office Applications and databases.
• Valid Driver’s license required.

Responsibilities

• Serve as the clinical manager for an assigned caseload of Members.
• Participate as an active member of a multi/inter-disciplinary team to assess and plan care needs.
• Conduct on-site reviews and assess medical necessity and eligibility for community case management.
• Prepare and maintain Member service records and coordinate service delivery.
• Document information in data systems per guidelines.
• Engage providers and state agencies for comprehensive reviews.
• Evaluate and modify services as required.
• Maintain confidential records and write clinical summaries.

Skills

RN licensure MA

Case management

Interdisciplinary collaboration

Office applications

Driver’s license

Travel statewide

Tools

Microsoft Office

Job description

University of Massachusetts Medical School seeks a Nurse Reviewer II to provide administrative case management for the Community Case Management Program. You will coordinate long-term services, assess care needs, and collaborate with nursing providers, state agencies, hospitals, and programs to ensure continuity of care.

The role requires MA RN licensure, 5–7 years of experience with pediatric to medically complex populations, and statewide travel.