New

Nurse Case Manager

Mass General Brigham (Enterprise Services)
United States, Massachusetts, Somerville
399 Revolution Drive (Show on map)
May 06, 2025
As part of the larger Patient Transfer and Access Center (PTAC) team, the nurse case manager will screen transfers in and out of MGB facilities for key case management elements. Using advanced case management skills, the PTAC nurse case manager will research patient-specific needs, explore all of the options available to the patient for high quality care, and coordinate services within and external to the MGB healthcare system. Serves 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 Job 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. Communicates with third-party payers to obtain necessary authorization for reimbursement of services. Qualifications: Associate's Degree in Nursing required Bachelor's Degree in Nursing preferred Registered Nurse Licensed in MA 2-3 years of case management, utilization review, or discharge planning experience preferred Knowledge, Skills and Abilities 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. Identify complex problems and review 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. M-F, mostly onsite at Assembly Row, Somerville, MA. Mass General Brigham Incorporated 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.