Complex Care Manager, RN

Site: Mass General Brigham Community Physicians, Inc. Job Summary Serves as a core member of the care team coordinating and supporting healthcare within the facility and coordinating 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 Functions Client Assessments and Planning. Modify patient treatment plans as indicated by patients' responses and conditions. Prepare patient/family for discharge. Communicate with third party payers to obtain necessary authorization for reimbursement of services. Review cases with medical directors on challenging cases as needed. Define care goals of patients by providing education, information, and direction to each individual and family. Maintain accurate, detailed reports and records. Qualifications Associate's Degree Nursing or Bachelor's Degree Nursing required. Massachusetts Registered Nurse (RN) License. 2+ years case management, utilization review, discharge planning or home care experience strongly preferred. Additional Knowledge, Skills, and Abilities Give full attention to others, understand points being made, ask appropriate questions, and avoid interrupting at inappropriate times. Use logic and reasoning to identify strengths and weaknesses of alternative solutions, conclusions, or approaches to problems. Establish strong rapport and relationships with patients and staff. Proficient in Microsoft Office and related industry software programs. Identify complex problems and review related information to develop and evaluate options and implement solutions. Maintain client and staff confidentiality. Understand diagnostic criteria for dual conditions and conceptualize modalities and placement criteria within the continuum of care. Knowledge of healthcare and managed care preferred. Schedule and Work Model Full-time Monday through Friday, approximately 8am-4:30pm; some flexibility with hours. Primarily remote. Meetings at Assembly Row in Somerville, MA twice per month. On remote workdays, employees must use a stable, secure, and compliant workstation in a quiet environment. Teams Video is required and must be accessed using MGB-provided equipment. Location 399 Revolution Drive Compensation Annual: $58,656.00 - $142,448.80 EEO Statement 6010 Mass General Brigham Community Physicians, 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. #J-18808-Ljbffr Mass General Brigham