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Boston Medical Center

Complex Care Manager RN

Boston Medical Center, Cambridge, Massachusetts, us, 02140

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Overview

The Complex Care Manager works with relevant stakeholders to identify and engage patients in care management with a focus on patient experience, improving health and reducing cost. This individual will direct and manage Community Health Workers and/or Patient Navigators in completion of assigned patient care related tasks. The individual is responsible for working with patients to identify strengths and barriers and to develop an individualized, patient-centered care plan. Excellent interpersonal skills, clinical expertise in conditions prevalent in the Medicaid population (Substance Use Disorder, Serious Mental Illness, Congestive Heart Failure [CHF, etc.]), patient engagement skills and the ability to work independently and collaboratively are key requirements of the job.

Position Summary

This position is Monday - Friday, 40 hours FTE, no weekends or holidays observed by BMC. Business hours, typically between 8:30 am - 5 pm. This position is a blended hybrid role, offering opportunities for both in person and remote work from home. Candidates must have a working vehicle and be able to travel independently. This role serves patients in the Brockton, Randolph, Raynham, Bridgewater, Easton and Quincy Communities. This position allows approximately 2 days per week working from home, approximately 3 days working in the community, practice site, patient home settings. The dress code is business casual.

Responsibilities

Identify and recruit appropriate patients for care management from lists and referrals, in collaboration with supervisors and local clinical site leaders

Execute core care management duties: Comprehensive assessment: bio-psycho-social-spiritual

Collaborate with patient and care team to develop patient-centered care plan, with focus on chronic disease management, social determinants, transitions of care and advanced care planning (HCP, MOLST)

Implement care plan

Collaborate with community partners, such as VNA agencies, caregiver programs (PCA, ADH, AFC), DME providers and social service agencies; assess goal completion, with transition of patient to inactive or graduated status as appropriate

Use reflective, empathetic language and open-ended questions to understand what the patient truly wants for him/herself beyond being healthy and staying out of the hospital

Meet the patient where he/she is; observe the patient without intervention or judgment

Has knowledge of common chronic medical conditions presented in the population served and is able to: Educate the patient on their medication conditions and medications, and build their self-management skills

Use motivational interviewing to promote behavioral change

Assess, triage, and rapidly respond to clinical changes that could lead to the need for emergency services if not intervened upon

Collaborates with Community Health Workers and/or Social Workers

Meets regularly with leaders at the local clinical site (Primary Care, ED, inpatient), and care management supervisor, to triage program issues appropriately

Participates in local site operations, including team meetings, curbsides with care team members, etc.

Actively participates in planning and growth of program with relevant stakeholders as needed, to respond to evolving needs of MassHealth ACO

Facilitates interdisciplinary consultation on patient’s behalf through participation in rounds, team meetings and clinical reviews

Complies with established metrics for performance and adheres to documentation and workflow standards

Maintains HIPAA standards and confidentiality of protected health information

Adheres to departmental/organizational policies and procedures

Care Manager must be available to work at the clinic site on assigned practice days in person

Metrics

ED and inpatient visits

Total medical expense

Patient satisfaction

Clinical outcomes

Provider satisfaction

Avoidable admissions

Other duties as assigned Job Requirements

Education: Nursing degree: Diploma, ASN or BSN/Masters (preferred); Ability to obtain BSN within 4 years

CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED : Licensed to practice professional nursing as a Registered Nurse in the Commonwealth of Massachusetts. AND/OR Completed an accredited educational program for Nurse Practitioners Experience: A minimum of two years of clinical experience is preferred, with care management experience preferred Preferred experience: Experience working with vulnerable patient populations

Home care or clinic

Motivational interviewing

Clinical experience working with patients with multiple complex health issues

Care management

Knowledge and Skills: Excellent interpersonal skills and ability to work collaboratively

Self-management skills, including ability to prioritize and set patient-centered goals

Excellent written and verbal communication

Able to maintain professional boundaries

Ability to work with diverse, safety-net population

Skilled at engaging difficult to engage patients—build rapport, trust

Creative problem solver

Ability to adapt to changes in healthcare delivery at local and systems level

Extensive knowledge of healthcare systems and community resources

Ability to leverage systems and resources for improved patient outcomes

Strong organizational and time management skill

Equal Opportunity Employer/Disabled/Veterans According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website and applications are received only through our website. We do not ask or require downloads of any applications, or “apps” job offers are not extended over text messages or social media platforms. We do not ask individuals to purchase equipment for or prior to employment.

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