RN Case Manager - Care Coordination & Telehealth

Fallon Health; Massachusetts; On-site; USD 95,000 - 100,000; Full time

Job summary

Fallon Health in Massachusetts seeks an RN Case Manager to join our interdisciplinary team. You will coordinate care for NaviCare members, perform transition of care assessments, and create care plans to meet complex needs.

You will conduct face-to-face and telephonic visits, reconcile medications, educate members on benefits, and collaborate with PCPs, pharmacists, Navigators, and community partners to improve access and outcomes.

Qualifications

• RN with Massachusetts license active, unrestricted.
• Certification in Case Management strongly desired, willing to obtain.
• 1+ year of clinical RN experience with complex medical, behavioral, and social co-morbidities.
• Driving your personal motor vehicle is an essential job function with a valid license and insurance.

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.
• Collaborate with Navigators, PCPs, Behavioral Health Case Managers, pharmacists, and community partners.
• Track progress toward goals and adjust care plans as needed.
• Participate in interdisciplinary rounds and team communication.

Skills

Nursing

Care coordination

Communication

Interdisciplinary teamwork

Education

Associate's degree in nursing

Bachelor's degree in nursing preferred

Job description

Fallon Health in Massachusetts seeks an RN Case Manager to join our interdisciplinary team. You will coordinate care for NaviCare members, perform transition of care assessments, and create care plans to meet complex needs.

You will conduct face-to-face and telephonic visits, reconcile medications, educate members on benefits, and collaborate with PCPs, pharmacists, Navigators, and community partners to improve access and outcomes.