RN Case Manager: Care Coordination & Telehealth

Fallon Health; Lowell (MA); On-site; USD 95,000 - 100,000; Full time

Job summary

Fallon Health is seeking an RN Case Manager in Massachusetts to join an interdisciplinary care team focused on NaviCare member care coordination and quality. The role requires driving face-to-face and telephonic assessments, creating and updating care plans, and collaborating with Navigators, PCPs, and pharmacists to meet regulatory standards.

The position emphasizes medication reconciliation at transitions, patient education, and outcomes improvement, with a pay range around $95,000–$100,000

Qualifications

• 1+ years of clinical RN experience with complex medical, behavioral, and social co-morbidities.
• Ability to conduct assessments in-person and telehealth.
• Ability to work on interdisciplinary teams.
• Skill in screening social determinants of health.
• Strong communication and interviewing skills; problem-solving and adaptability.
• Knowledge or willingness to learn regulatory requirements.

Responsibilities

• 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 based on assessments.
• Coordinate services and authorize care according to standards.
• Collaborate with Navigators, PCPs, Behavioral Health Case Managers, pharmacists, and partners.
• Track progress toward goals and adjust care plans as needed.
• Participate in interdisciplinary rounds and team communication.
• Build relationships with members, caregivers, and providers for coordinated care.
• Complete assessments, notes, and care plans within regulatory timelines; uphold HIPAA.

Skills

RN experience

Interdisciplinary teamwork

Telehealth assessments

Care coordination

Communication skills

Problem-solving

Education

Associate degree in Nursing

Bachelor’s degree in Nursing (preferred)

Job description

Fallon Health is seeking an RN Case Manager in Massachusetts to join an interdisciplinary care team focused on NaviCare member care coordination and quality. The role requires driving face-to-face and telephonic assessments, creating and updating care plans, and collaborating with Navigators, PCPs, and pharmacists to meet regulatory standards.

The position emphasizes medication reconciliation at transitions, patient education, and outcomes improvement, with a pay range around $95,000–$100,000