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Fallon Health - Worcester, MA
posted about 2 months ago
Full-time
Worcester, MA
Hospitals
About the position
The Clinical Integration Nurse Case Manager (NCM) plays a crucial role in an interdisciplinary team focused on care coordination and management for Fallon Health members. The NCM is responsible for establishing relationships with members and caregivers, conducting assessments, and facilitating services to meet member needs according to their care plans. This position emphasizes improving access to quality care and ensuring compliance with regulatory requirements.
Responsibilities
- Telephonically assess and case manage a panel of members.
- Conduct in-home face-to-face visits for onboarding new enrollees and reassessing members.
- Attend in-person care plan meetings with providers and office staff.
- Complete Program Assessments, Notes, Screenings, and Care Plans in the Centralized Enrollee Record according to regulatory requirements.
- Demonstrate positive customer service actions to meet member and provider requests.
Requirements
- Graduate from an accredited school of nursing.
- Active, unrestricted RN license in Massachusetts.
- 1+ years of clinical experience as a Registered Nurse managing chronically ill members or in a coordinated care program.
- Understanding of hospitalization experiences and post-discharge needs.
- Experience with telephonic interviewing skills and working with diverse populations.
Nice-to-haves
- Bachelor's (or advanced) degree in nursing or a healthcare-related field.
- Certification in Case Management.
- Home Health Care experience.
Benefits
- Prescription drug insurance
