At Mass General Brigham, we know it takes a surprising range of talented professionals to advance our mission—from doctors, nurses, business people and tech experts, to dedicated researchers and systems analysts. As a not-for-profit organization, Mass General Brigham is committed to supporting patient care, research, teaching, and service to the community. We place great value on being a diverse, equitable and inclusive organization as we aim to reflect the diversity of the patients we serve.
At Mass General Brigham, we believe a diverse set of backgrounds and lived experiences makes us stronger by challenging our assumptions with new perspectives that can drive revolutionary discoveries in medical innovations in research and patient care. Therefore, we invite and welcome applicants from traditionally underrepresented groups in healthcare — people of color, people with disabilities, LGBTQ community, and/or gender expansive, first and second-generation immigrants, veterans, and people from different socioeconomic backgrounds – to apply.
Job Summary
Summary<br>Serves as core member of 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 program and surrounding counties. Ensures coordination and planning with the inclusion of community and family support. Focuses on the development and coordination of community service plans. Partners with service providers, families, and patient to create plan of healthcare and identifies additional service providers.<br><br>Does this position require Patient Care?<br>Yes<br><br>Essential Functions<br>-Client Assessments and Planning <br>-Modify patient treatment plans as indicated by patients' responses and conditions. <br>
-Prepare patient/family for discharge <br>
-Communicates with third party payers to obtain necessary authorization for reimbursement of services. <br>
-Review cases with medical directors on challenging cases as needed <br>
-Defines care goals of patients by providing education, information, and direction to each individual and family. <br>
-Maintain accurate, detailed reports and records. <br>
-Communicates with third party payers to obtain necessary authorization for reimbursement of services. <br>
Qualifications
Education
Associate's Degree Nursing required or Bachelor's Degree Nursing preferred
Can this role accept experience in lieu of a degree?
No
Licenses and Credentials
Registered Nurse [RN - State License] - Generic - HR Only required Basic Life Support [BLS Certification] - Data Conversion - Various Issuers preferred
Experience
case management, utilization review, or discharge planning experience 2-3 years preferred
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)
Home Base
Home Base, a Red Sox Foundation and Massachusetts General Hospital program, is dedicated to healing the invisible wounds – including post-traumatic stress, traumatic brain injury, anxiety, depression, co-occurring substance use disorder, family relationship challenges and other issues associated with Military service – for Veterans of all eras, Service Members, Military Families and Families of the Fallen through world-class clinical care, wellness, education, and research.
At Home Base, you are seen, heard, and treated with dignity and respect. We are committed to embodying values of anti-racism, diversity, equity, and inclusion. We recognize and work collaboratively to address disparities. We strive to foster an inclusive team environment in which each person has an experience of being valued and respected regardless of their intersecting identities.
Home Base is part of Massachusetts General Hospital, an Equal Opportunity Employer. By embracing diverse individuals, skills, perspectives, and ideas, we choose to lead. Applications from protected Veterans and individuals with disabilities are strongly encouraged.
Principle Duties & Responsibilities:
Facilitating Post-Care Coordination: Working closely with Home Base Program leadership, clinicians, and administrative staffs, the Home Base Program Nurse Case Manager is responsible for coordinating care to the appropriate internal MGB and/or external clinicians.
Manages the coordination of care for Home Base patients, and support persons when participating, with dedicated focus on Brain Health patients, in need of care and/or services from physicians, the VA system, other agencies from regional, national, and international communities as needed. Manages the post evaluation coordination of care for patients and support persons in need of services and/or resources from healthcare providers, the VA system, or other agencies in their respective regional, national, and international communities as recommended by Home BaseMeets 1 on 1 with Brain Health patients (and support person(s) as appropriate) at the end of their assessment week to review assessments, recommendations and answer any questions, and field and triage any concerns.Primary responsibility for tracking and providing monthly follow up calls for individual Brain Health patients at home following program.Assist in triage of medical and psychiatric urgencies/emergenciesServes as central contact point for patients presenting with questions or concerns following their attendance of the evaluation program.Interfaces with patient’s home providers to ensure continuity of care as indicated and agreed upon by patient.Advocates and relays questions or concerns from patient to Home Base clinician(s) and providers within the MGB Healthcare System as indicated to support follow up care. Notifies referring physician of the specifics of the referral that has been made.Ensures timely access for patients to their testing reports and results.Communicates patient and family needs to appropriate clinicians.Maintains familiarity with the activities and interests of all programs within Home Base, MGB Healthcare System to provide the most appropriate coordination of care and triage into the Home Base Program.Promotes direct and timely access and problem solving for urgent clinical situations.Identifies and helps to resolve service delivery problems and recommends methods to improve and streamline services.Works with the Home Base program clinicians, support staff, and administrators, to establish processes for prompt resolution of patient and/or caregiver grievances.Physical Requirements
Standing Frequently (34-66%)Walking Frequently (34-66%)Sitting Occasionally (3-33%)Lifting Frequently (34-66%) 35lbs+ (w/assisted device)Carrying Frequently (34-66%) 20lbs - 35lbsPushing Occasionally (3-33%)Pulling Occasionally (3-33%)Climbing Rarely (Less than 2%)Balancing Frequently (34-66%)Stooping Occasionally (3-33%)Kneeling Occasionally (3-33%)Crouching Occasionally (3-33%)Crawling Rarely (Less than 2%)Reaching Frequently (34-66%)Gross Manipulation (Handling) Frequently (34-66%)Fine Manipulation (Fingering) Frequently (34-66%)Feeling Constantly (67-100%)Foot Use Rarely (Less than 2%)Vision - Far Constantly (67-100%)Vision - Near Constantly (67-100%)Talking Constantly (67-100%)Hearing Constantly (67-100%)
Remote Type
Hybrid
Work Location
One Constitution Wharf
Scheduled Weekly Hours
40
Employee Type
Regular
Work Shift
Day (United States of America)
EEO Statement:
The General Hospital Corporation is an Affirmative Action 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.
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.