Nurse Case Manager

Mass General Brigham Nursing PositionServes as a core member of the care team, coordinates and supports healthcare within the facility, and coordinates referrals for services outside the clinic. Provides outreach and enrollment services to meet eligibility requirements of the program and surrounding counties. Ensures coordination and planning, including community and family support. Focuses on the development and coordination of community service plans. Partners with service providers, families, and patients to create a plan of healthcare and identify additional service providers.Essential FunctionsClient Assessments and PlanningPrepare patient/family for dischargeCommunicates with third party payers to obtain necessary authorization for reimbursement of servicesReview cases with medical directors on challenging cases as neededDefines care goals of patients by providing education, information, and direction to each individual and familyMaintain accurate, detailed reports and recordsQualificationsEducation: Associate's Degree Nursing required or Bachelor's Degree Nursing preferredLicenses and Credentials: Registered Nurse [RN - State License] - Generic - HR Only required Basic Life Support [BLS Certification] - Data Conversion - Various Issuers preferredExperience: Case management, utilization review, or discharge planning experience 2-3 years preferredKnowledge, Skills and Abilities: Giving full attention to what other people are saying, using logic and reasoning to identify the strengths and weaknesses of alternative solutions, establishing strong rapport and relationships with patients and staff, proficient in Microsoft Office and industry related software programs, maintaining client and staff confidentiality, understanding of diagnostic criteria for dual conditions and the ability to conceptualize modalities and placement criteria within the continuum of care, knowledge of Healthcare and Managed Care preferredPhysical RequirementsStanding Frequently (34-66%)Walking Frequently (34-66%)Sitting Occasionally (3-33%)Lifting Frequently (34-66%) 35lbs+ (w/assisted device)Carrying Frequently (34-66%) 20lbs - 35lbsPushing Occasionally (3-33%)Pulling Occasionally (3-33%)Climbing Rarely (Less than 2%)Balancing Frequently (34-66%)Stooping Occasionally (3-33%)Kneeling Occasionally (3-33%)Crouching Occasionally (3-33%)Crawling Rarely (Less than 2%)Reaching Frequently (34-66%)Gross Manipulation (Handling) Frequently (34-66%)Fine Manipulation (Fingering) Frequently (34-66%)Feeling Constantly (67-100%)Vision - Far Constantly (67-100%)Vision - Near Constantly (67-100%)Talking Constantly (67-100%)Hearing Constantly (67-100%)Remote Type: RemoteWork Location: One Hospital RoadScheduled Weekly Hours: 24Employee Type: RegularWork Shift: Day (United States of America)Pay Range: $58,656.00 - $142,448.80/AnnualGrade: 98TEMPEEO Statement:Martha's Vineyard Hospital, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at View phone number on click.appcast.io.Mass General Brigham Competency FrameworkAt Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.