Nurse Care Manager - Sturdy

What You'll Do

• Develop trusting relationship with patients by providing support and advocacy to help achieve health goals
• Coordinate transitions of patients to/from acute inpatient, skilled nursing and other settings
• Assist patients in accessing community resources (e.g., food stamps, meals on wheels, subsidized housing, free legal services, Medicaid/Medicare applications, support groups etc.)
• Meet with patients in patient-centered and patient-preferred locations (e.g., center, facility, home, community setting)
• Manage low-risk referrals defined by care management program (Medical Social Work) & collaborate with social worker on action plan
• Afford high-risk individuals (e.g., completed specialty appointments, adherence to post-discharge visits); may include accompanying patients to appointments
• Assist completion of applications to access eligible benefits
• Perform wellness checks in homes, participate in remote monitoring program education on individuals with specific health conditions
• Deliver health education presentations
• Facilitate communication between all identified parties by the patient involved in care (e.g., family members, care givers, medical providers, community-based organizations)
• Coach / train early career Care Managers, potentially in a management role
• Any other related duties assigned at manager’s discretion

Qualifications

• Current unrestricted Massachusetts RN license required
• Previous work experience in a primary care setting, emergency medicine setting, care management role, and/or a home care manager
• Must be a self-directed individual able to work diligently without direction, think critically and prioritize
• Demonstrated experience with Electronic Medical Records (EMR) systems, with a strong preference for proficiency in EPICCCM (Certified Case Manager) or ACM (Accredited Case Manager)
• Bachelor's degree or higher, preferred
• Experience working with aging population and/or community health, preferred
• Knowledge of health plans, Medicare, Medicaid, preferred

PREFERRED QUALIFICATIONS

• Current unrestricted Compact Nurse Licensure in addition to MA RN license
• CCM (Certified Case Manager) or ACM (Accredited Case Manager)
• Bachelor's degree or higher
• Experience working with aging population and/or community health
• Knowledge of health plans, Medicare, Medicaid
• Verifiable good driving record and reliable transportation