Site: Mass General Brigham Community Physicians, Inc.

Job Summary
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.

Essential Functions:

-Client Assessments and Planning.
-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

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:

- 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.

Additional Job Details (if applicable)

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.

Remote Type

Hybrid

Work Location

399 Revolution Drive

Scheduled Weekly Hours

40

Employee Type

Regular

Work Shift

Day (United States of America)

Pay Range
$58,656.00 - $142,448.80/Annual

Grade
98TEMP

At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.

Mass General Brigham Competency Framework

At 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.