RN Case Manager

Jobtailor; Lynn (MA); On-site; USD 90,000 - 120,000; Full time

Job summary

Jobtailor is seeking an RN case manager to coordinate comprehensive care for older adults in the PACE program in Massachusetts. You will develop and monitor individualized care plans, conduct assessments, and coordinate services across medical, behavioral health, therapy, and community resources.

As the primary nursing case manager, you will collaborate with physicians, nurse practitioners, therapists, social workers, and other team members.

Qualifications

• Active RN license in Massachusetts.
• Minimum two years of RN experience.
• Home health, case management, community health, or geriatric nursing experience preferred.
• Strong assessment, care coordination, and communication skills.
• Ability to work independently while collaborating within an interdisciplinary team.
• Valid driver's license and reliable transportation for community visits.
• EMR experience preferred.

Responsibilities

• Coordinate comprehensive care for older adults enrolled in the PACE program.
• Develop, implement, and monitor individualized care plans to promote independence and reduce hospitalizations.
• Conduct participant assessments and coordinate services across medical, behavioral health, therapy, and community resources.
• Serve as the primary nursing case manager and collaborate with physicians, nurse practitioners, therapists, social workers, and the interdisciplinary team.
• Maintain continuity of care through ongoing follow-up, education, and care coordination.
• Complete timely documentation utilizing the electronic medical record system.

Job description

• Coordinate comprehensive care for older adults enrolled in the Program of All-Inclusive Care for the Elderly (PACE)
• Develop, implement, and monitor individualized care plans that promote independence and reduce unnecessary hospitalizations
• Conduct participant assessments and coordinate services across medical, behavioral health, therapy, and community resources
• Serve as the primary nursing case manager while collaborating with physicians, nurse practitioners, therapists, social workers, and additional interdisciplinary team members
• Maintain continuity of care through ongoing participant follow-up, education, and care coordination
• Complete timely documentation utilizing the electronic medical record system

Requirements

• Active Registered Nurse (RN) license in Massachusetts
• Minimum two years of Registered Nurse experience
• Home health, case management, community health, or geriatric nursing experience preferred
• Strong assessment, care coordination, and communication skills
• Ability to work independently while collaborating within an interdisciplinary team
• Valid driver's license and reliable transportation for community visits
• Electronic medical record experience preferred

Core Competencies

Demonstrates expertise in coordinating comprehensive care for older adults, including developing and monitoring individualized care plans, conducting assessments, and ensuring continuity of care through effective communication and collaboration with interdisciplinary teams.