RN Care Navigator – Telehealth & In-Home Case Management

Fallon Community Health Plan, Inc.; Worcester (MA); Presencial; USD 95.000 - 100.000; Jornada completa

Descripción de la vacante

Fallon Health in Worcester, MA is seeking an experienced RN Case Manager to join our interdisciplinary care team. The NCM will build relationships with members and caregivers, conduct assessments, develop and update care plans, and coordinate transitions of care, medication reconciliation, and community referrals to ensure high-quality, member-centered care.

Responsibilities include completing assessments within regulatory timelines, supporting HEDIS/5-Star initiatives, and collaborating with

Formación

• 1+ years of clinical RN experience with complex medical, behavioral, and social co-morbidities.
• Ability to conduct assessments in-person and via telehealth.
• Ability to work on interdisciplinary teams.
• Knowledge of social determinants of health.
• Strong communication and problem-solving skills.

Responsabilidades

• Assess and manage a member panel through in-person and telephonic outreach.
• Complete medication reconciliations and care transition assessments.
• Educate members on benefits, rights, disease management, medications, and preventive screenings.
• Support member self-management through coaching and health education.
• Develop and update individualized care plans and coordinate services.
• Collaborate with Navigators, PCPs, Behavioral Health Case Managers, pharmacists, and community partners.
• Complete assessments, screenings, and care plans within regulatory timelines.

Conocimientos

RN experience

Interdisciplinary teamwork

Telehealth

Care coordination

Education on health benefits

Educación

Associate degree in Nursing

Bachelor’s degree preferred

Descripción del empleo

Fallon Health in Worcester, MA is seeking an experienced RN Case Manager to join our interdisciplinary care team. The NCM will build relationships with members and caregivers, conduct assessments, develop and update care plans, and coordinate transitions of care, medication reconciliation, and community referrals to ensure high-quality, member-centered care.

Responsibilities include completing assessments within regulatory timelines, supporting HEDIS/5-Star initiatives, and collaborating with