Complex Care Manager RN

Primary Responsibilities

• Modify patient treatment plans as indicated by patients' responses and conditions.
• Prepare patient/family for discharge.
• Communicates with third party payers to obtain necessary authorization for reimbursement of services.
• Review cases with medical directors on challenging cases as needed.
• Defines care goals of patients by providing education, information, and direction to each individual and family.
• Maintain accurate, detailed reports and records.

• Associate's Degree Nursing or Bachelor's Degree Nursing required.
• Massachusetts Registered Nurse (RN) License required.
• 3+ years RN experience required.
• Valid Driver's License and reliable transportation required.
• Basic Life Support (BLS) Certification preferred.
• 2+ years case management, utilization review, or discharge planning experience preferred.

• Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.
• Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
• Ability to establish strong rapport and relationships with patients and staff.
• Proficient in Microsoft Office and industry related software programs.
• Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions.
• Ability to maintain 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 preferred.

• Full-time (40 hours) Monday through Friday, standard business hours.
• Location:
  
  Newton/Wellesley/Needham.
• Hybrid work model. Approximately 2-3 days in the practice and field, approximately 2-3 days at home.
• Remote work days require stable, secure, quiet, compliant work station.

Mass General Brigham Community Physicians, Inc. is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. 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.