RN Case Manager (Contract)

About Vitra Health

Vitra Health is a mission-driven healthcare organization committed to improving the quality of life for individuals and families across Massachusetts. Through innovative home- and community-based services, Vitra supports aging adults, people with disabilities, and individuals with complex care needs. Our interdisciplinary team works collaboratively to ensure adult foster care clients receive compassionate, personalized, and dignified care while remaining safely in their homes and communities.

Position Summary

Vitra Health is seeking Temporary Nurse Case Managers (RN) to provide in-person regional coverage and support on a contract basis. This role is responsible for conducting assessments, coordinating care, educating clients and caregivers, monitoring client well-being, and ensuring compliance with program and regulatory requirements.

The Temporary Nurse Case Manager serves as a key member of the interdisciplinary care team, helping clients access healthcare services, navigate community resources, and maintain safe, independent living whenever possible.

Key Responsibilities

Clinical Assessments & Care Planning

• Complete in-person intake, admission, annual, and reassessment visits in accordance with program requirements.
• Conduct nursing assessments and evaluate clients' physical, psychosocial, and environmental needs.
• Collaborate with interdisciplinary team members to develop, implement, review, and update individualized plans of care.
• Assist with medication reviews and care plan updates as appropriate.
• Participate in discharge planning and ongoing care coordination activities.

Client & Caregiver Support

• Provide education to clients and caregivers regarding health maintenance, disease prevention, medication management, and available community resources.
• Review admission materials and ensure clients and caregivers understand program requirements and expectations.
• Provide caregiver education and skills training to support quality care delivery.
• Assist clients and families with accessing healthcare services, community programs, and support resources.

Ongoing Monitoring & Case Management

• Conduct regular in-home visits to monitor client health, caregiver performance, psychosocial well-being, and environmental safety.
• Assess and address concerns related to changes in physical health, psychosocial status, or living conditions.
• Review caregiver communication tools and documentation requirements.
• Communicate professionally with clients, caregivers, primary care providers, and other healthcare professionals as needed.
• Participate in multidisciplinary team meetings and collaborate to address client needs.

Documentation & Compliance

• Complete all required documentation at point of service accurately and timely in accordance with organizational policies and state regulations.
• Maintain accurate detailed records of assessments, care plans, visits, interventions, and client outcomes.
• Ensure compliance with all applicable regulatory, clinical, and program requirements.
• Foster culture of customer service and commitment to quality care.  
• Serve as a brand ambassador for Vitra reflecting our vision, mission, and values.  
• Show genuine interest and compassion and commitment to the diversity of our clients and team members.  
• Must use company-provided tablets for all documentation.
• Other duties as assigned. 

Qualifications

• Current Massachusetts nursing license in good standing (RN).
• Minimum of two (2) years of recent experience providing direct care to elders or adults with disabilities.
• Valid driver's license, reliable transportation, and proof of insurance.
• Willingness and ability to travel throughout assigned regions.
• Strong communication, interpersonal, documentation, and organizational skills.
• Ability to work independently while effectively managing multiple priorities.
• Strong problem-solving and critical-thinking abilities.

Preferred

• Experience in case management, home health, community health, adult foster care (AFC), group adult foster care (GAFC), behavioral health, or social services.
• Experience coordinating care and navigating community resources.
• English as a primary or secondary language
• Experience working with diverse populations in community-based healthcare settings.

Work Environment and Physical Requirements

• Travel throughout region conducting home visits.
• Office-based work in a clean well-lit environment with fluctuating temperatures near others.
• Client-facing field staff and community liaisons require frequent travel to client homes or community settings; ability to drive safely; work in client homes may involve varying temperatures, odors, allergens, pets, and other environmental factors.
• Requires substantial periods of repetitive work utilizing a computer, monitor, keyboard, and mouse.
• Requires lifting and carrying equipment and supplies weighing up to 35 pounds; requires pushing and pulling equipment and supplies weighing up to 35 pounds; requires walking and standing; requires frequent sitting more than 75% of the workday; requires the ability to negotiate stairs; requires visual acuity and manual dexterity to operate equipment.

Vitra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.