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GQR Healthcare is seeking a travel nurse RN Case Management for a travel nursing job in Everett, Massachusetts. Job Description & Requirements • Specialty: Case Management, • Discipline: RN, • Start Date: ASAP, • Duration: 13 weeks, • 40 hours per week, • Shift: 8 hours, days, • Employment Type: Travel Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Everett, Massachusetts Start Date: January 27, 2026 Profession: Registered Nurse (RN) Facility: Estimated Pay: $2989.6 - $3084.6 Duration:13 weeks Specialty:Case Management/Utilization Review Shift: Day Shift Details: null Day Job Type: Travel *Estimated weekly pay includes projected hourly wages and weekly meal and lodging per diems for eligible clinicians based on nationally published GSA rates. Actual weekly pay and per diems may differ from the amount shown and are subject to change during an assignment. Benefits: • Day 1 Insurance, • Cigna medical, MetLife dental and vision insurance, • License reimbursement for new licenses needed for each assignment, • Discounts with hotels and rental cars, • A dedicated recruiter and support team that will help you every step of the way to sure you start on time and have an exceptional experience, • Referral bonus up to $700 About the Company: Finding the right role is about more than just matching skills to a job—it’s about aligning with your goals, values, and the way you want to work. As an award-winning talent partner, we support healthcare professionals through every step of that process, offering meaningful opportunities, clear guidance, and long-term partnership. From our first conversation to your first day on the job (and beyond!), we’re here to help you move forward with confidence. GQR Job ID #754953. Pay package is based on 8 hour shifts and 40 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: Registered Nurse (RN) About GQR Healthcare GQR’s Healthcare team specializes in connecting experts within the industry to highly skilled healthcare professionals across the US market. In the competitive healthcare market, we recognize that the industry’s common goals of improved quality of care and patient outcomes are wholly reliant upon the professionals directly supporting these initiatives. Leveraging our extensive candidate network, we deliver continuity of care for the communities our partners serve to ensure the patient experience is of the highest quality. Through deep market specialization and a unique approach to talent acquisition, GQR Healthcare provides an unparalleled and personalized experience across all medical specialties in nursing and within diverse healthcare platforms across the industry.

Access Healthcare is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Somerville, Massachusetts. Job Description & Requirements • Specialty: Utilization Review, • Discipline: RN, • Duration: 13 weeks, • 40 hours per week, • Shift: 9 hours, days, • Employment Type: Travel REMOTE position: Mon- Fri, 8am-5:00pm, no weekends, no holidays. Essential Functions-Supervise and support a team of care coordinators and case managers, ensuring they adhere to clinical standards and protocols. -Develop and implement strategies to enhance the efficiency and effectiveness of clinical care coordination. -Monitor patient care processes and outcomes to ensure compliance with regulatory requirements and hospital policies. -Facilitate collaboration between clinical teams, physicians, and other healthcare providers to optimize patient care. -Review and analyze patient data to identify trends, areas for improvement, and opportunities for intervention. -Conduct regular performance evaluations and provide ongoing training and development for staff members. -Manage case load assignments and prioritize patient cases based on acuity and resource availability. -Oversee the implementation of new care models or technologies to improve patient care and operational efficiency. -Ensure accurate documentation and reporting of case management activities and patient care outcomes.Hiring RequirementsJob DetailsJob ProfileJob ProfileJP202967 - Manager, ClinicalJob Families for Job ProfilesJob Families for Job Profiles119 - Care Coordination / Case ManagementWorker Sub-TypeWorker Sub-TypeRegularWorker TypeWorker TypeEmployeeTime TypeTime TypeFull timeEmployee Contract TypeEmployee Contract Type(empty)Compensation GradeCompensation Grade8Remote TypeRemote TypeRemotePrimary LocationPrimary Location399 Revolution Drive Somerville (Assembly Row Main Building)Primary Job Posting LocationPrimary Job Posting LocationSomerville-MAAdditional LocationsAdditional Locations(empty)Additional Job Posting LocationsAdditional Job Posting Locations(empty)Scheduled Weekly HoursScheduled Weekly Hours40Work ShiftWork ShiftDay (United States of America)Recruiting Start DateRecruiting Start Date03/30/2026Target Hire DateTarget Hire Date04/06/2026Target End DateTarget End Date(empty)Additional InformationUnion Membership from Job ProfileUnion Membership from Job Profile(empty)Allowed Unions from Job ProfileAllowed Unions from Job Profile(empty)Collective Agreement DetailsCollective AgreementCollective Agreement(empty)Job DescriptionJob DescriptionEducationBachelor's Degree requiredMaster's Degree Related Field of StudyLicenses and CredentialsMassachusetts Registered Nurse [RN] license requiredExperienceAt least 3-5 years of experience in clinical care coordination or case management requiredLTSS (Long-Term Services and Supports) experience preferredAt least 2-3 years of experience in a supervisory or leadership role requiredAt least 2-3 years of Medicare and DSNP UM experience requiredKnowledge, Skills, and AbilitiesStrong leadership and team management skills to effectively guide and support clinical staff.Excellent communication and interpersonal skills to collaborate with healthcare providers and patients.Analytical skills to assess patient care data and identify areas for improvement.Problem-solving abilities to address complex care coordination issues and implement effective solutions.Knowledge of regulatory requirements and industry best practices in clinical care and case management.Proficiency in healthcare management software and electronic health record systems. Access Healthcare Job ID #5-MGB-27877. Pay package is based on 9 hour shifts and 40 hours per week (subject to confirmation) with tax-free stipend amount to be determined. About Access Healthcare Access Healthcare aims to provide superior service to our nursing family by providing around the clock support, competitive pay packages and an unmatched benefits package! Unlike other agencies, we offer a true family feel and work with you to find the placement that is right for you. We offer one of the top leading pay packages in the industry and we are ready to get you the money you deserve! Access Healthcare was founded by two travel nurses, Danielle and Diego, who had a dream and a shared vision of creating an agency which all nurses would want to work with. Our passion has led us to where we are today as one of the top 10 agencies in our home state of New Jersey, with access to contracts in all 50 states! We encourage you to join our team and we cannot wait to get to know you!

MedPro Healthcare Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Boston, Massachusetts. Job Description & Requirements • Specialty: Case Management, • Discipline: RN, • Start Date: 07/05/2026, • Duration: 13 weeks, • 40 hours per week, • Shift: 10 hours, days, • Employment Type: Travel MedPro Healthcare Staffing, a Joint Commission-certified staffing agency, is seeking a quality Case Manager Registered Nurse (RN) for a travel assignment with one of our top healthcare clients. Requirements • Eighteen months of recent experience in an Acute Care Case Manager setting, • Active RN License, • BLS Certifications, • Degree from accredited nursing program Benefits • Weekly pay and direct deposit, • Full coverage of all credentialing fees, • Private housing or housing allowance, • Group Health insurance for you and your family, • Company-paid life and disability insurance, • Travel reimbursement, • 401(k) matching, • Unlimited Referral Bonuses up to $1,000 Duties Responsibilities The role of the case management nurse (RN) is to coordinate continuity of care for patients often as a liaison between the patient’s family and healthcare organization. Work is administered in a variety of settings, including HMOs, community health organizations, long-term care facilities, behavioral health programs, rehabilitation centers, schools, and case management companies • Coordinate continuity of care for patients often as a liaison between the patient’s family and healthcare organization, • Strives to promote self-managed care and the use of healthcare resources in the most cost-effective way possible, • Ensure that the proper treatment is administered at the appropriate time in order to maximize health and well-being About Agency MedPro Healthcare Staffing is a Joint Commission certified provider of contract staffing services. Since 1983, we have placed nursing and allied travelers in top healthcare facilities nationwide. Join us today for your very own MedPro Experience®. If qualified and interested, please call for immediate consideration. MedPro Staffing is an Equal Opportunity Employer. All applicants will be considered for employment without attention to race, color, religion, national origin, age, sex, disability, marital status or veteran status. Key Words: RN Travel, Travel Nurse, Contract Nurse, Agency Nurse, Travel Contract, Travel Nursing, Case Manager, Case Management, Utilization Review, Case Manager RN *Weekly payment estimates are intended for informational purposes only and include a gross estimate of hourly wages and reimbursements for meal, incidental, and housing expenses. Your recruiter will confirm your eligibility and provide additional details. MedPro Job ID #a0Fcx00000NZ6OfEAL. Pay package is based on 10 hour shifts and 40 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: Case Manager Registered Nurse Nursing: Case Manager. About MedPro Healthcare Staffing At MedPro Healthcare Staffing, we believe no one cares more for caregivers than we do. Our mission is simple: you focus on your patients, and we’ll take care of the rest. As a Joint Commission-certified leader in temporary and contract healthcare staffing since 1983, MedPro has proudly connected nursing and allied travelers with top healthcare facilities across the nation. With thousands of job opportunities available nationwide, we make it easy to find assignments that align with your goals and lifestyle. Our on-staff clinical support team—alongside a compassionate group of experienced recruiters—provides hands-on guidance every step of the way. From Day 1 medical benefits and a 401(k) plan to personalized career support, we’re committed to ensuring every professional we serve feels valued, cared for, and empowered to succeed. Guided by a CEO who is a Registered Nurse, MedPro is built on a foundation of clinical insight and genuine compassion for the caregiving community. Through The MedPro Experience®, we deliver travel assignments that are rewarding, memorable, and designed to help you DREAM big, EXPLORE often, and ACHIEVE greatness. Benefits • Day 1 medical, dental, and vision benefits for you and your family, • Weekly pay and direct deposit, • Unlimited Referral Bonuses starting at $500, • On Staff Clinical Support Team, • Access to nationwide travel assignments, • MPX+ Mobile app -24/7 real-time access to jobs, credentials, assignment details, and more, • Full coverage of all credentialing fees, • Private housing or housing allowance, • Tax Free Per Diems, Housing Stipends and Travel Reimbursements, • Company-paid life and disability insurance, • Travel reimbursement, • 401(k) matchingBenefits, • Weekly pay, • Referral bonus, • Employee assistance programs

Job Description: Position Summary: In collaboration with the attending physician, the Geriatric Nurse Practitioner will provide care to patients in one or more clinical venues of the Hebrew Rehabilitation Center. Services will focus on the management of chronic and episodic illness. Core Competencies: Ability to work effectively within a team, group, and across the organization to accomplish tasks and achieve desired results. Display enthusiasm and promote a friendly working situation; support group decision-making and solicit opinions from co-workers. Ability to increase understanding of others by noticing, interpreting, and anticipating feelings and concerns of others; respecting, valuing, and using individual differences to generate new opportunities and enhance solutions. Ability to absorb, comprehend, and exchange information with others in a way that enhances mutual understanding of ideas, issues, and desired actions; Ability to listen well. Ability to use and expand the technical body of knowledge to continuously improve work and share information with others. Ability to demonstrate attention to detail, follow specific procedures, and ensure accuracy in documentation and data. Ability to stay informed of current industry trends, to learn and apply new concepts; Ability to identify own areas of opportunity and set and monitor self-development goals. Ability to energize others; exhibit a can-do approach and inspire colleagues to excel. Ability to demonstrate tact, maintain confidences, and foster an ethical work environment. Demonstrate integrity by giving proper credit to others and by handling all situations honestly. Ability to establish a collaborative primary care practice with the PCP. Position Responsibilities: Performs initial and periodic assessments of patients and appropriately identifies and documents problems and issues in the medical record. Evaluates episodic illnesses and issues, and appropriate diagnostic and therapeutic orders. Collaborates with physicians and other multi-disciplinary team members to manage the episodic and chronic medical needs of the patients. Performs diagnostic and therapeutic interventions as indicated. Implements plan of care safely and effectively. Evaluates the effectiveness of previously implemented treatment. Participates in multi-disciplinary meetings as indicated. Documents each patient encounter in a timely manner (typically the same day) using the appropriate electronic medical record system Signs/completes documentation in a timely manner to allow for submission of charges by the off-site billing company Identifies utilization and service delivery problems and participates in their resolution. Participates in quality assessment activities, including but not limited to record reviews, outcome measurement, and review and revision of policies and procedures. Provides education and training to residents, caregivers, and staff in relevant topics. Serves on appropriate committees; participates in staff meetings. Enhances professional growth and self- development through participation in research activities, other professional activities, educational programs, current literature, in-service programs, and workshops. The above covers the most significant responsibilities of the position. It does not, however, exclude other duties, which would conform to the level of the position. Completes special projects as assigned. Qualifications Education: Master's Degree required. Graduate of an accredited Nurse Practitioner program. License: Licensed as a nurse practitioner by the Commonwealth of Massachusetts Board of Registration in Nursing. Certification: National Certification as Geriatric, Adult, or Family Nurse Practitioner. Experience: Four years of Nurse Practitioner experience preferred. Two years as a nurse or nurse practitioner in a geriatric facility preferred. Remote Type: On-site Salary Range: $114,658.36 - $171,987.53

American Traveler is seeking a travel nurse RN Case Management for a travel nursing job in Cambridge, Massachusetts. Job Description & Requirements • Specialty: Case Management, • Discipline: RN, • Start Date: 06/08/2026, • Duration: 13 weeks, • 40 hours per week, • Shift: 8 hours, days, • Employment Type: Travel Assignment Overview • Shift: Days, 5x8hrs, • Hours: 40 hrs/wk, • Start Date: Jun 8, 2026, • Length: 13 weeks, • Openings: 1Description American Traveler is seeking an experienced RN Case Manager for a contract position at a rehabilitation hospital in Cambridge, MA, requiring an active MA RN license and Epic experience. Details • Day shift position, 8:00 AM – 4:30 PM, • Case Management unit within a rehabilitation hospital setting in Cambridge, MA, • Responsibilities span both inpatient coordination and referrals for post-discharge community services, • Uses Epic for charting, • UKG/Kronos used for timekeepingRequirements, • Active MA RN license required — no pending or conditional licenses accepted, • Minimum 2 years of case management experience required, • BLS certification required — AHA only; Red Cross and other providers are not accepted for this facility, • Epic EMR experience required, • 2 professional references required for consideration, • Flu vaccine required; no religious or medical exemptions are acceptedAdditional Information, • Conducts client assessments and develops individualized care plans in collaboration with patients, families, and service providers, • Modifies treatment plans based on patient responses and changing conditions, • Communicates with third-party payers to obtain authorizations for reimbursement of services, • Coordinates discharge planning and prepares patients and families for transitions to community-based care, • Maintains accurate documentation and detailed case records, • Collaborates with the medical team on complex or challenging cases, • Local candidates with a permanent residence within 60 miles of Massachusetts General Hospital in Boston are eligible to apply, • No validated parking is available at Boston-area locations; public transportation is recommended, and public parking rates range from $17–$22 per day, • Any requested time off (RTO) must be disclosed at the time of consideration American Traveler Job ID #P-706521. Pay package is based on 8 hour shifts and 40 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: Travel RN - Case Management/Utilization Review - Case Management About American Traveler With over 25 years of experience, American Traveler has established a reputation for outstanding customer service. Our team ensures a smooth, worry-free experience for those starting on or expanding their travel nursing and allied careers. With thousands of travel nursing and allied jobs nationwide, our attentive and approachable recruiters find positions that align perfectly with your career aspirations and personal requirements. American Traveler offers exceptional benefits, including premium medical, dental, vision and life insurance beginning day one of your assignment, generous 401(k) match, substantial housing stipends, and more. Additionally, with 24/7 support and access to our in-house clinicians, you are assured confidence and comfort throughout your assignment. With our team behind you, you can relax and enjoy a rewarding travel career.

American Traveler is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Boston, Massachusetts. Job Description & Requirements • Specialty: Utilization Review, • Discipline: RN, • Start Date: ASAP, • Duration: 13 weeks, • 40 hours per week, • Shift: 8 hours, days, • Employment Type: Travel Assignment Overview • Shift: Days, 5x8hrs, • Hours: 40 hrs/wk, • Start Date: May 4, 2026, • Length: 13 weeks, • Openings: 2Description American Traveler is hiring a travel RN Case Manager for an acute care case management role in Boston, MA, requiring an active MA RN license and a minimum of 2 years of experience. Details • Hospital-based acute care setting within a Care Continuum/Case Management unit, • Day shift schedule: 8:00 AM – 4:30 PM, 5 days per week (5x8), • 13-week contract with potential for extension, • Epic used for chartingRequirements, • Active MA RN license required — conditional licenses are accepted provided the permanent licensure process has already been initiated, • Minimum 2 years of RN case management experience required, • Acute care case management experience required, • All certifications must be issued by the American Heart Association (AHA), • Flu vaccine required; no religious or medical exemptions are accepted, • 2 professional references required for considerationAdditional Information, • Prior travel nursing experience is a plus, • Candidates with a conditional MA license may be considered; the assignment term will align with the duration of the conditional license, with extension reviewed upon issuance of the permanent license, • RTO requests must be disclosed at the time of consideration, • Local candidates residing within 60 miles of the Boston facility are eligible to apply, • No validated parking is available at this Boston location; public transportation is encouraged, and public parking is available at an estimated cost of $17–$22 per day, • Timekeeping is managed through UKG/Kronos American Traveler Job ID #P-692583. Pay package is based on 8 hour shifts and 40 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: Travel RN - Case Management/Utilization Review - Case Management About American Traveler With over 25 years of experience, American Traveler has established a reputation for outstanding customer service. Our team ensures a smooth, worry-free experience for those starting on or expanding their travel nursing and allied careers. With thousands of travel nursing and allied jobs nationwide, our attentive and approachable recruiters find positions that align perfectly with your career aspirations and personal requirements. American Traveler offers exceptional benefits, including premium medical, dental, vision and life insurance beginning day one of your assignment, generous 401(k) match, substantial housing stipends, and more. Additionally, with 24/7 support and access to our in-house clinicians, you are assured confidence and comfort throughout your assignment. With our team behind you, you can relax and enjoy a rewarding travel career.

Job Description Job Title: RN Manager, Clinical Resource Management (Travel) Location: Hyannis, MA Type: Contract Position Overview: Navitas Healthcare, LLC is seeking RN Manager, Clinical Resource Management for an exciting Travel job in Hyannis, MA. Responsibilities • Provide leadership and management of Case Management and Social Work teams, including staffing, scheduling, coaching, and performance evaluations, • Collaborate with operational leadership to support Clinical Documentation Integrity (CDI) initiatives, • Conduct patient care rounds to identify barriers to discharge and facilitate timely transitions of care, • Oversee discharge planning, utilization management, and care coordination activities, • Support high-risk and complex patient populations through effective resource management, • Provide onboarding, training, and mentorship for clinical staff and interdisciplinary team members, • Educate staff on utilization review processes, discharge planning requirements, and regulatory updates, • Monitor compliance metrics and departmental performance indicators, • Develop reporting tools and dashboards to identify improvement opportunities, • Lead process improvement initiatives to enhance operational efficiency, patient outcomes, and regulatory compliance, • Analyze performance data and implement evidence-based improvement strategies, • Promote interdisciplinary collaboration and support organizational quality initiatives Requirements • Bachelor of Science in Nursing (BSN) required, • Current Massachusetts Registered Nurse (RN) License required, • Minimum 5 years of Case Management experience in an acute care hospital setting required, • Minimum 3 years of acute care clinical experience within the past 5 years required, • Minimum 2 years of process improvement experience required, • Working knowledge of InterQual or equivalent utilization management tools required, • Experience developing and presenting professional education programs, • Strong leadership, analytical, communication, and organizational skills, • Experience with discharge planning, utilization review, and care coordination Preferred Qualifications • Master’s Degree preferred, • Certification in Case Management (CCM) preferred, • Certification in Clinical Documentation Integrity (CDI) preferred, • Previous leadership, supervisory, or management experience preferred For more details contact at hdavda@navitashealth.com or Call / Text at 516-862-1169. About Navitas Healthcare, LLC: It is a Joint Commission Certified / WBENC and one of the fastest-growing healthcare staffing firms in the US providing Medical, Clinical and Non-Clinical services to numerous hospitals. We offer the most competitive pay for every position we cater. We understand this is a partnership. You will not be blindsided and your salary will be discussed upfront.

Job Description Case Management Registered Nurse (RN) – Travel Location: Hyannis, MA 02601 Duration: 13 Weeks Shift: Day | 5×8s Type: Contract / Travel Travel Pay Range: $65–$70/hour ($2,600–$2,800 weekly) Overview: "Navitas Healthcare, LLC" is seeking Case Management Registered Nurse for an exciting job in Hyannis, MA. Responsibilities: Assess new admissions and identify discharge planning needs. Perform initial and ongoing clinical assessments using InterQual® or similar criteria. Conduct utilization reviews and collaborate with payers to ensure authorization and reimbursement. Coordinate interdisciplinary care plans and complex discharge arrangements. Educate patients/families on care options, coverage, and authorization status. Arrange post-acute care with community or home health providers. Support quality initiatives and ensure accurate, compliant documentation. Adhere to hospital policies, safety, and infection control standards. Qualifications: Active Massachusetts RN license. 3+ years recent acute care experience. Strong background in discharge planning and/or utilization review. Experience with InterQual® or similar clinical review tools. BSN and CCM/CPUM certification preferred. Excellent communication, critical thinking, and EMR proficiency. For more details contact at pmohanty@navitashealth.com or Call / Text at 516-806-4227. About Navitas Healthcare, LLC certified WBENC and one of the fastest-growing healthcare staffing firms in the US providing Medical, Clinical and Non-Clinical services to numerous hospitals. We offer the most competitive pay for every position we cater. We understand this is a partnership. You will not be blindsided and your salary will be discussed upfront.

Job Description Job Title: RN Manager, Clinical Resource Management (Travel) Location: Hyannis, MA Type: Contract Position Overview: Navitas Healthcare, LLC is seeking RN Manager, Clinical Resource Management for an exciting Travel or Local job in Hyannis, MA. Responsibilities • Provide leadership and management of Case Management and Social Work teams, including staffing, scheduling, coaching, and performance evaluations, • Collaborate with operational leadership to support Clinical Documentation Integrity (CDI) initiatives, • Conduct patient care rounds to identify barriers to discharge and facilitate timely transitions of care, • Oversee discharge planning, utilization management, and care coordination activities, • Support high-risk and complex patient populations through effective resource management, • Provide onboarding, training, and mentorship for clinical staff and interdisciplinary team members, • Educate staff on utilization review processes, discharge planning requirements, and regulatory updates, • Monitor compliance metrics and departmental performance indicators, • Develop reporting tools and dashboards to identify improvement opportunities, • Lead process improvement initiatives to enhance operational efficiency, patient outcomes, and regulatory compliance, • Analyze performance data and implement evidence-based improvement strategies, • Promote interdisciplinary collaboration and support organizational quality initiatives Requirements • Bachelor of Science in Nursing (BSN) required, • Current Massachusetts Registered Nurse (RN) License required, • Minimum 5 years of Case Management experience in an acute care hospital setting required, • Minimum 3 years of acute care clinical experience within the past 5 years required, • Minimum 2 years of process improvement experience required, • Working knowledge of InterQual or equivalent utilization management tools required, • Experience developing and presenting professional education programs, • Strong leadership, analytical, communication, and organizational skills, • Experience with discharge planning, utilization review, and care coordination Preferred Qualifications • Master’s Degree preferred, • Certification in Case Management (CCM) preferred, • Certification in Clinical Documentation Integrity (CDI) preferred, • Previous leadership, supervisory, or management experience preferred For more details contact at hdavda@navitashealth.com or Call / Text at 516-862-1169. About Navitas Healthcare, LLC: It is a Joint Commission Certified / WBENC and one of the fastest-growing healthcare staffing firms in the US providing Medical, Clinical and Non-Clinical services to numerous hospitals. We offer the most competitive pay for every position we cater. We understand this is a partnership. You will not be blindsided and your salary will be discussed upfront.

Job Description Job Title: RN Manager, Clinical Resource Management (Travel) Location: Hyannis, MA Type: Contract Position Overview: Navitas Healthcare, LLC is seeking RN Manager, Clinical Resource Management for an exciting Travel job in Hyannis, MA. Responsibilities • Provide leadership and management of Case Management and Social Work teams, including staffing, scheduling, coaching, and performance evaluations, • Collaborate with operational leadership to support Clinical Documentation Integrity (CDI) initiatives, • Conduct patient care rounds to identify barriers to discharge and facilitate timely transitions of care, • Oversee discharge planning, utilization management, and care coordination activities, • Support high-risk and complex patient populations through effective resource management, • Provide onboarding, training, and mentorship for clinical staff and interdisciplinary team members, • Educate staff on utilization review processes, discharge planning requirements, and regulatory updates, • Monitor compliance metrics and departmental performance indicators, • Develop reporting tools and dashboards to identify improvement opportunities, • Lead process improvement initiatives to enhance operational efficiency, patient outcomes, and regulatory compliance, • Analyze performance data and implement evidence-based improvement strategies, • Promote interdisciplinary collaboration and support organizational quality initiatives Requirements • Bachelor of Science in Nursing (BSN) required, • Current Massachusetts Registered Nurse (RN) License required, • Minimum 5 years of Case Management experience in an acute care hospital setting required, • Minimum 3 years of acute care clinical experience within the past 5 years required, • Minimum 2 years of process improvement experience required, • Working knowledge of InterQual or equivalent utilization management tools required, • Experience developing and presenting professional education programs, • Strong leadership, analytical, communication, and organizational skills, • Experience with discharge planning, utilization review, and care coordination Preferred Qualifications • Master’s Degree preferred, • Certification in Case Management (CCM) preferred, • Certification in Clinical Documentation Integrity (CDI) preferred, • Previous leadership, supervisory, or management experience preferred For more details contact at hdavda@navitashealth.com or Call / Text at 516-862-1169. About Navitas Healthcare, LLC: It is a Joint Commission Certified / WBENC and one of the fastest-growing healthcare staffing firms in the US providing Medical, Clinical and Non-Clinical services to numerous hospitals. We offer the most competitive pay for every position we cater. We understand this is a partnership. You will not be blindsided and your salary will be discussed upfront.

Job Description Job Title: Manager – Clinical Resource / Case Management Location: Hyannis, MA Duration: 13 Weeks (Extendable) Shift Details: • Monday – Friday, 8-hour day shifts, • Rotating on-call for weekends and holidays Weekly Compensation: Up to $3,000 (based on experience) Position Summary The Manager of Clinical Resource / Case Management is responsible for overseeing daily operations and providing clinical leadership for Case Management, Utilization Review, and Social Work services. This role supports care coordination, discharge planning, and high-risk patient management while ensuring compliance with regulatory standards and optimizing patient outcomes. The position also plays a key role in staff development, process improvement initiatives, and collaboration across multidisciplinary teams. Key ResponsibilitiesLeadership & Department Operations • Oversee day-to-day operations of Case Management and Social Work teams, • Manage staff scheduling, workflow, and performance evaluations, • Support clinical documentation processes in collaboration with leadership, • Mentor, coach, and develop team members to enhance performanceCare Coordination & Discharge Planning, • Conduct patient rounds to identify discharge barriers and facilitate transitions of care, • Ensure effective discharge planning and utilization management, • Collaborate with physicians, nurses, and interdisciplinary teamsEducation & Staff Development, • Develop and deliver continuing education programs, • Provide onboarding and role-specific training for new staff, • Educate clinical teams on utilization review and discharge planning processesQuality Improvement & Compliance, • Monitor compliance metrics and identify performance gaps, • Develop dashboards and reports to track outcomes, • Lead process improvement initiatives, • Ensure adherence to regulatory standards and best practicesAnalytics & Reporting, • Analyze operational and departmental performance metrics, • Utilize case management systems to drive improvements, • Present data-driven recommendations to leadershipRequired Qualifications, • Active Registered Nurse (RN) license (state-specific), • Bachelor of Science in Nursing (BSN) required, • Minimum 3 years of recent acute care clinical experience, • Minimum 5 years of Case Management experience in an acute care setting, • Minimum 2 years of process improvement experience, • Working knowledge of utilization review systems (e.g., InterQual® or equivalent), • Knowledge of healthcare regulations and reimbursement processes (e.g., CMS), • Experience developing and delivering education programs, • Strong computer skills (Windows-based applications), • Excellent organizational, analytical, and communication skillsPreferred Qualifications, • Master’s degree in Nursing or related field, • Certification in Case Management (CCM) and/or Clinical Documentation Integrity (CDI), • Prior management or supervisory experience, • Experience leading multidisciplinary healthcare teamsWork Environment, • Acute care hospital setting, • Leadership role requiring collaboration across departments, • Focus on patient-centered care, compliance, and operational efficiencyAdditional Notes, • Candidates must be flexible for on-call responsibilities, • Strong emphasis on leadership, quality improvement, and team development For more details reach at Aditi.sharma@navitashealth.com or Call / Text at 516-587-6677. About Navitas Healthcare, LLC: It is a Joint Commission Certified / WBENC and one of the fastest-growing healthcare staffing firms in the US providing Medical, Clinical and Non-Clinical services to numerous hospitals. We offer the most competitive pay for every position we cater. We understand this is a partnership. You will not be blindsided, and your salary will be discussed upfront.

Job Description School Nurse Practitioner (FNP) needed for a school in Boston (starting 9/2026 with the school year) Schedule: Monday through Friday 7:30am-2:30pm *10-month calendar year - Off from June-Sept (Still paid during this time when permanent) Temp-to-perm role! Temp Pay: $65-70/hour (based on experience) City of Boston Residency Required: (Allston, Back Bay, Bay Village, Beacon Hill, Brighton, Charlestown, Chinatown, Dorchester, Downtown, East Boston, Fenway-Kenmore, Hyde Park, Jamaica Plain, Mattapan, Mid-Dorchester, Mission Hill, North End, Roslindale, Roxbury, South Boston, South End, West End, West Roxbury, Wharf district) Offers comprehensive primary care + reproductive services to students in grades 7-12. Active DEA license preferred Primary care experience a must. Peds/adolescence experience required. Job Description The NP delivers primary care services to students, acts as manager for the site, and collaborates with other members of the team. The NP establishes and maintains collegial relationships with school administrators, teachers, nurses, and staff and works to improve optimum health and educational outcomes for all students through joint efforts of home, school, clinic, and community. The expanded services will be rendered in addition to, not in lieu of, those currently provided by the school nurse. Duties • Performs physical examinations as related to illness or health maintenance., • Compiles medical records with complete and accurate information according to company standards., • Performs basic laboratory work., • Participates in the development of clinical policies and protocols., • Counsels students regarding physical and emotional health issues and makes appropriate referrals., • Provides health education to individuals and groups in the school, clinical, and community settings., • Participates in peer review and other means of evaluation., • Provides clinical instruction to health professionals in accordance with company standards of practice., • Participates in school collaboration and outreach activities as appropriate to increase utilization., • Attends mandatory Massachusetts Department of Public Health meetings., • Working to help company become an antiracist organization by meeting or exceeding the standards set by the company Anti-Racism Policy., • Performs other duties as required. Minimum Qualifications FNP in Massachusetts ???????• MSN. Certification and MA license to practice in the expanded role. • Eligible for prescriptive writing privileges., • 2 years clinical experience., • Promote health equity, inclusion, and diversity within the department and community., • Knowledge of or willingness to learn about the role of public health in addressing racism, the social determinants of health, and inequities in health outcomes as well as strategies to advance racial justice and health equity., • Experience in working with a culturally diverse adolescent population., • Computer proficiency helpful., • Fluency in a second language helpful. #zip

Job Description Summary Under general supervision, the MRI technologist will safely perform magnetic resonance imaging (MRI) studies using a magnetic resonance imaging system. The scope of the MRI technologist includes preparing patients, positioning, setting imaging parameters, acquiring images, performing computer processing, and displaying images. The MRI technologist selects appropriate imaging protocols for patient studies and performs quality assurance scans as required. The MRI technologist demonstrates the ability to work cohesively as a team member within the MRI Department and consults appropriate content experts as needed. (ie radiologist, nurse, child life specialist) Staff must demonstrate the ability to rotate to MRI scanners across the assigned department as needed. Staff must be available to work occasional overnight shifts as well as holidays, as deemed necessary by the department, with the exception of per-diem technologists. Per Joint Commission (JC) guidelines, confirms patient name, date of birth, medical record number, and MRI exam ordered with each patient. Demonstrates ability to prepare patient, positions for exam, set imaging parameters per protocol, perform computer processing, and displays images at request for both clinical and research patients. Must be competent in managing ambulatory/outpatient patients needing MRI exams with and without contrast. Inserts IV catheters as need and prepares for and performs intravenous injection of MR contrast agents to include the use of the MR compatible power injector. Understands and can communicate the possible contraindications as well as monitor for and respond to adverse reactions to MR contrast agents. Records all information regarding contrast injections appropriately in electronic medical record (EMR) Performs point of care testing (POCT) where applicable. Instructs patients and visitors on MRI safety procedures and ensures adherence to safety policies by all persons entering the MRI area. Functions as final check point, prior to scanning, for patient safety and protocol clarification per department policy. In addition, Identifies hazardous system malfunctions; secures area and removes patients and personnel from magnet bay during emergency situations. Performs scheduled quality control procedures on MRI scanner and other related equipment. Records QA results as required. Reports any potential equipment related problems to supervisor as necessary. Assists Practice Assistant and other department staff in various duties as necessary (i.e. scheduling and transporting patients, taking stock inventory, filing, etc.). Education Other Certificate/Diploma Medical Imaging required or Associate's Degree Medical Imaging preferred Can this role accept experience in lieu of a degree? No Licenses and Credentials Magnetic Resonance Imaging [R.T.(MR)(ARRT)] - American Registry of Radiologic Technologists (ARRT) preferred MRI Technologist - American Registry of Magnetic Resonance Imaging Technologists (ARMRIT) preferred Experience MRI Tech experience with multiple patient populations 0-1 year required Knowledge, Skills and Abilities • Ability to operate complex electronic equipment and instrumentation and perform quality control procedures where appropriate., • Ability to transfer patients to the MRI scan table and push the table from the prep room to the exam room; must lift and transfer patients to stretchers., • Must demonstrate the ability to provide appropriate care to various age populations. In addition, may oversee students within the department and may be required to work with lab animals for research purposes., • Maintains ethical standards (patient confidentiality, professional conduct, etc.)., • Utilizes departmental-specific tools to confirm contrast dosing and patient safety. These tools include the EMR MRI search engine, electronic dose calculators, image review systems (PACS), and other means designated by the department., • Works collaboratively with the local MRI leadership team to ensure smooth efficient patient flow and optimal utilization of the MRI scanners. Maintains effective working relationships and communication with all departmental staff and other hospital personnel. 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 - 35lbs, • Pushing 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%) 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.

Commonwealth Care Alliance (CCA) is a nonprofit, mission-driven health plan and care delivery organization designed for individuals with the most significant needs. As an affiliate of CareSource, a nationally recognized nonprofit managed care organization with over 2 million members across multiple states, CCA serves individuals enrolled in Medicaid and Medicare in Massachusetts through the Senior Care Options and One Care programs and its care delivery enterprises. CCA is dedicated to delivering comprehensive, integrated, and person-centered care, powered by its unique model of uncommon care, which yields improved quality outcomes and lower costs of care. Job Summary: The Clinical Care Manager-Massachusetts is a community based registered nurse responsible for providing monitoring, follow-up and clinical care management to dually-eligible enrollees with complex medical, behavioral and social care needs. This position focuses on integrating health services and community resources to coordinate enrollee care for improve health outcomes and enhanced quality of life. Essential Functions: • Engage with the enrollee in their homes and other community settings to establish an effective, complex care management relationship, while considering the cultural and linguistic needs of each member., • Function as a liaison between healthcare providers, community resources, and enrollees to ensure seamless communication and care transitions., • Perform required assessments on a timely basis, including but not limited to Comprehensive Assessment, MDS-HC (or successor) Functional Assessments, and Crisis and Risk Assessments, • Engage enrollees in care plan development and implementation, providing routine updates as the enrollee's status changes, • Lead the interdisciplinary care team (ICT) and collaborate with peers both internal and external to the organization, to create holistic care plans that address medical and non-medical needs., • Oversee enrollee utilization of long-term services and supports, ensuring appropriate systems are in place for enrollees to remain in the location of their choice, • Assist members in accessing community resources, including housing, transportation, food assistance, and social services., • Educate members about their benefits and available services under both Medicare and Medicaid., • Provide education to members and their families about managing chronic conditions, medication adherence, and preventive care., • Promote healthy lifestyle choices and self-management strategies., • Assist enrollees in preventative health strategies, including gap closure, • Follow up with members after hospitalizations or significant health events to ensure continuity of care and prevent readmissions., • Work closely with primary care physicians, specialists, and other healthcare providers to coordinate care and share relevant information., • Coordinate with community-based organizations, other stakeholders/entities, state agencies, and other service providers to ensure coordination and avoid duplication of services., • Advocate for the needs and preferences of enrollees within the healthcare system., • Evaluate member satisfaction through open communication and monitoring of concerns or issues., • Regular travel to conduct member, provider and community-based visits as required, • Report abuse, neglect, or exploitation of older adults and adults with disabilities as a mandated reporter as required by State law., • Adherence to NCQA and Care Management standards, • Performs any other job related duties as requested. Education and Experience: • Associates of Science (A.S) degree in nursing from an accredited nursing program required or, • Master's degree in social work or mental health counseling and independent license required, • Three (3) years of experience as a Registered Nurse/BH Clinician or, • One (1) year as a Registered Nurse/BH Clinician with two (2) years of experience working with people with complex medical, behavioral and social needs as an LPN, CHW, MA required, • Prior experience in care coordination, case management, or working with dual-eligible populations preferred, • Medicaid and/or Medicare managed care experience preferred Competencies, Knowledge and Skills:, • Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel., • Understanding of Medicare and Medicaid programs, as well community resources and services available to dual-eligible beneficiaries., • Strong interpersonal and communication skills to effectively engage with members, families, and healthcare providers, • Ability to manage multiple cases and priorities while maintaining attention to detail., • Adhere to code of ethics that aligns with professional practice., • Awareness of and sensitivity to the diverse backgrounds and needs of the populations served, • Decision making and problem-solving skills., • Ability to function independently and effectively as part of an interdisciplinary team, • Strong and effective communication skills, both written and verbal, • Strong interpersonal and customer relations skills, • Strong customer service skillsLicensure and Certification:, • Current unrestricted clinical license in the Commonwealth of Massachusetts as a Registered Nurse (RN), Licensed Clinical Social Worker (LCSW), Licensed Independent Clinical Social Worker (LISCW), or a Licensed Mental Health Counselor (LMHC) required, • Case Management Certification is highly preferred, • Must have valid driver's license, vehicle and verifiable insurance. Employment in this position is conditional pending successful clearance of a driver's license record check. If the driver's license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in this position will be terminated, • To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 - March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified., • CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process.Working Conditions:, • This is a mobile position, meaning that regular travel to different work locations, including homes, offices or other public settings, is essential. Will be exposed to weather conditions typical of the location and may be required to stand and/or sit for long periods of time. Must reside in the same territory they are assigned to work in; exceptions may be considered, due to business need May be required to travel greater than 50% of time to perform work duties. Required to use general office equipment, such as a telephone, photocopier, fax machine, and computer Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our members, • Must live within commutable distance to the Commonwealth of Massachusetts, • Over 50% (Mobile) Routine travel required Compensation Range: $90,000 - $120,000 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type: Salary Competencies: • Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

Commonwealth Care Alliance (CCA) is a nonprofit, mission-driven health plan and care delivery organization designed for individuals with the most significant needs. As an affiliate of CareSource, a nationally recognized nonprofit managed care organization with over 2 million members across multiple states, CCA serves individuals enrolled in Medicaid and Medicare in Massachusetts through the Senior Care Options and One Care programs and its care delivery enterprises. CCA is dedicated to delivering comprehensive, integrated, and person-centered care, powered by its unique model of uncommon care, which yields improved quality outcomes and lower costs of care. Job Summary: The Clinical Care Manager-Massachusetts is a community based registered nurse responsible for providing monitoring, follow-up and clinical care management to dually-eligible enrollees with complex medical, behavioral and social care needs. This position focuses on integrating health services and community resources to coordinate enrollee care for improve health outcomes and enhanced quality of life. Essential Functions: • Engage with the enrollee in their homes and other community settings to establish an effective, complex care management relationship, while considering the cultural and linguistic needs of each member., • Function as a liaison between healthcare providers, community resources, and enrollees to ensure seamless communication and care transitions., • Perform required assessments on a timely basis, including but not limited to Comprehensive Assessment, MDS-HC (or successor) Functional Assessments, and Crisis and Risk Assessments, • Engage enrollees in care plan development and implementation, providing routine updates as the enrollee's status changes, • Lead the interdisciplinary care team (ICT) and collaborate with peers both internal and external to the organization, to create holistic care plans that address medical and non-medical needs., • Oversee enrollee utilization of long-term services and supports, ensuring appropriate systems are in place for enrollees to remain in the location of their choice, • Assist members in accessing community resources, including housing, transportation, food assistance, and social services., • Educate members about their benefits and available services under both Medicare and Medicaid., • Provide education to members and their families about managing chronic conditions, medication adherence, and preventive care., • Promote healthy lifestyle choices and self-management strategies., • Assist enrollees in preventative health strategies, including gap closure, • Follow up with members after hospitalizations or significant health events to ensure continuity of care and prevent readmissions., • Work closely with primary care physicians, specialists, and other healthcare providers to coordinate care and share relevant information., • Coordinate with community-based organizations, other stakeholders/entities, state agencies, and other service providers to ensure coordination and avoid duplication of services., • Advocate for the needs and preferences of enrollees within the healthcare system., • Evaluate member satisfaction through open communication and monitoring of concerns or issues., • Regular travel to conduct member, provider and community-based visits as required, • Report abuse, neglect, or exploitation of older adults and adults with disabilities as a mandated reporter as required by State law., • Adherence to NCQA and Care Management standards, • Performs any other job related duties as requested. Education and Experience: • Associates of Science (A.S) degree in nursing from an accredited nursing program required or, • Master's degree in social work or mental health counseling and independent license required, • Three (3) years of experience as a Registered Nurse/BH Clinician or, • One (1) year as a Registered Nurse/BH Clinician with two (2) years of experience working with people with complex medical, behavioral and social needs as an LPN, CHW, MA required, • Prior experience in care coordination, case management, or working with dual-eligible populations preferred, • Medicaid and/or Medicare managed care experience preferred Competencies, Knowledge and Skills:, • Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel., • Understanding of Medicare and Medicaid programs, as well community resources and services available to dual-eligible beneficiaries., • Strong interpersonal and communication skills to effectively engage with members, families, and healthcare providers, • Ability to manage multiple cases and priorities while maintaining attention to detail., • Adhere to code of ethics that aligns with professional practice., • Awareness of and sensitivity to the diverse backgrounds and needs of the populations served, • Decision making and problem-solving skills., • Ability to function independently and effectively as part of an interdisciplinary team, • Strong and effective communication skills, both written and verbal, • Strong interpersonal and customer relations skills, • Strong customer service skillsLicensure and Certification:, • Current unrestricted clinical license in the Commonwealth of Massachusetts as a Registered Nurse (RN), Licensed Clinical Social Worker (LCSW), Licensed Independent Clinical Social Worker (LISCW), or a Licensed Mental Health Counselor (LMHC) required, • Case Management Certification is highly preferred, • Must have valid driver's license, vehicle and verifiable insurance. Employment in this position is conditional pending successful clearance of a driver's license record check. If the driver's license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in this position will be terminated, • To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 - March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified., • CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process.Working Conditions:, • This is a mobile position, meaning that regular travel to different work locations, including homes, offices or other public settings, is essential. Will be exposed to weather conditions typical of the location and may be required to stand and/or sit for long periods of time. Must reside in the same territory they are assigned to work in; exceptions may be considered, due to business need May be required to travel greater than 50% of time to perform work duties. Required to use general office equipment, such as a telephone, photocopier, fax machine, and computer Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our members, • Must live within commutable distance to the Commonwealth of Massachusetts, • Over 50% (Mobile) Routine travel required Compensation Range: $90,000 - $120,000 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type: Salary Competencies: • Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

Primary Responsibilities: 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. - Client Assessments and Planning. - Modify patient treatment plans as indicated by patients' responses and conditions. -Prepare patient/family for discharge. -Communicate with third party payers to obtain necessary authorization for reimbursement of services. - Review cases with medical directors on challenging cases as needed. -Define care goals of patients by providing education, information, and direction to each individual and family. -Maintain accurate, detailed reports and records. Qualifications: Associate's Degree Nursing required. Bachelor's Degree Nursing preferred. Registered Nurse (RN) License for states of Massachusetts and New Hampshire required. If RN does not have NH license, must be willing to obtain. MGB will cover cost. 2+ years case management, utilization review, or discharge planning experience 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. Schedue and Working Model: Per Diem; approximately 30 hours per week, especially to start. Remote / Work from Home 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. Mass General Brigham Community Physicians, Inc. 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.

Across the country, governments, employers, and American families have struggled in the face of rising healthcare costs. Efforts historically have targeted narrow programs and patient populations, and while many have succeeded, healthcare costs continue to rise. It's time to take a radically different approach. A new approach involves putting the patient at the center with the goals of improving value and providing better outcomes at lower cost for patients. The Population Health Management (PHM) department at Mass General Brigham is charged with the challenge to drive better value for patients across Mass General Brigham. To achieve its goals, PHM leverages financial and clinical data to examine opportunities, designs and delivers innovative care models using product development and design thinking disciplines, and leverages problem solving, teamwork, and leadership skills to drive ongoing improvement. As an integral member of the Population Health Management Operations team, The Transition of Care Nurse Care Manager provides episodic care management for Medicare Shared Savings Program (MSSP) and Medicaid ACO patients from inpatient admission to home. This includes follow up phone calls after discharge, medication reconciliation, and ensuring patient has appropriate follow up appointments scheduled as well as documenting and ensuring all billing requirements are met prior to submitting TCM charges. The Transition of Care Nurse Manager directly interfaces with patients (via phone), Primary Care physicians, pharmacists, care managers, and health care teams involved in patient care as well collaborating with PHM Clinical Operations leadership. Primary Responsibilities: 1. Manages episodic transitions of care for Medicare Risk and Medicaid risk patients from inpatient discharge to home as applicable. a. Calls all discharged patients within two business days of discharge and conducts post discharge assessments. b. Works alongside the PHM Clinical Pharmacist to identify and perform Medication Reconciliation for identified patients within the two day follow up phone call. c. Reviews discharge instructions/paperwork prior to call to review with patient any action items needed prior to follow up appointment. d. Facilitate face to face follow-up appointment with their PCP within 7-14 days after discharge (or according to discharge instructions if applicable). e. Document patient interaction (phone calls) in the appropriate patient chart in the electronic medical record. f. Manages and coordinates transitions of care by communicating the care plan to other providers and care managers and applicable practice staff. g. Maintains all documentation according to standards and requirements. h. Ensures all Transitions of Care (TCMs) meet appropriate billing requirements prior to submitting documentation to the billing department per protocol yet TBD. 2. Demonstrates effective teamwork and collaboration with the primary care provider and the care team a. Engages the patient and caregiver as active members of the care team and facilitates an organized and effective, warm hand off for transitions of care back to the patient's medical home (PCP). b. Participates in regular meetings with the providers and the care team to identify opportunities for better transitions or to modify workflows as needed. c. Communicates with other PHM and (Regional Service Operation (RSO) departments and sites to foster collaboration as a 'system' around the patients served. Organizational Responsibilities: 1. Demonstrates a positive attitude in dealing with patients, co-workers, and other health care providers and in addressing problems and/or crisis situations. 2. Requires the ability to work independently as well as function effectively within a team-based model of care. 3. Able to establish collegial relationships with physicians, office staff and health care providers in physician's offices, community agencies, hospitals, and other health care facilities. 4. Functioning within the patient centered model of care, demonstrates a commitment to meeting the patient's needs and expectations. 5. Functioning within the team-based model of care 6. Demonstrates initiative and creativity to continuously improve services, work processes, and other activities that affect quality and utilization. 7. Follows applicable policies and procedures for general safety, fire safety, infection control, attendance, punctuality, and appearance. 8. Performs all duties as assigned. Other Duties and Responsibilities: 1. Assumes accountability for professional growth and development. 2. Acts as a role model for patients by practicing behaviors consistent with the program goals of health promotion and disease prevention. 3. Identifies quality of care issues and reports the concerns to the appropriate person. 4. Collects, prepares, and reports data as directed. 5. Assists in preparation for external audits and surveys as applicable. Qualifications Required: Associate's Degree Nursing (ASN) or Bachelor's Degree Nursing (BSN). RN License for State of MA. 3+ years of experience in hospital, health plan or community case management or utilization management role. Care management or home care background. Managed Care or previous healthcare reimbursement knowledge. Preferred: Understanding of diagnostic criteria for dual conditions and the ability to conceptualize modalities and placement criteria within the continuum of care. Certification in Case Management (CCM) and/or other applicable professional certification preferred. Previous experience working in a post-acute setting such as LTAC, acute rehabilitation, skilled nursing facility, or homecare. Bedside nursing experience. Additional Skills, Knowledge and Abilities: • Excellent organizational skills., • Excellent oral, written, and telephonic skills and abilities., • Critical thinking and problem-solving ability., • Demonstrated ability to present and speak in front of groups. -Demonstrated competency working with health care setting computer systems. -Competence in Microsoft Word, Excel and PowerPoint. -Ability to work effectively with physicians and their staff in a physician practice setting. -Ability to work a flexible schedule including some required evenings or early mornings. -Knowledge of levels of care and the continuum of health care services. -Ability to handle routine work, unexpected priorities, and multi-task. -Requires autonomy in decision making using sound judgment based upon factual information, clinical experience and nursing process. -Ability to work with various practice sites. Schedule and Work Model Full-Time Monday through Friday, standard business hours (approximately 8:30am-5pm ET) Remote with ability to travel to Assembly Row in Somerville, MA for team building, best practice sharing meetings and/or events. As a remote employee, must use a stable, secure, and compliant workstation in a quiet environment. Teams video is required and must be accessed using MGB-provided equipment. Mass General Brigham Community Physicians, Inc. 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.

Commonwealth Care Alliance (CCA) is a nonprofit, mission-driven health plan and care delivery organization designed for individuals with the most significant needs. As an affiliate of CareSource, a nationally recognized nonprofit managed care organization with over 2 million members across multiple states, CCA serves individuals enrolled in Medicaid and Medicare in Massachusetts through the Senior Care Options and One Care programs and its care delivery enterprises. CCA is dedicated to delivering comprehensive, integrated, and person-centered care, powered by its unique model of uncommon care, which yields improved quality outcomes and lower costs of care. Job Summary: The Clinical Care Manager-Massachusetts is a community based registered nurse responsible for providing monitoring, follow-up and clinical care management to dually-eligible enrollees with complex medical, behavioral and social care needs. This position focuses on integrating health services and community resources to coordinate enrollee care for improve health outcomes and enhanced quality of life. Essential Functions: • Engage with the enrollee in their homes and other community settings to establish an effective, complex care management relationship, while considering the cultural and linguistic needs of each member., • Function as a liaison between healthcare providers, community resources, and enrollees to ensure seamless communication and care transitions., • Perform required assessments on a timely basis, including but not limited to Comprehensive Assessment, MDS-HC (or successor) Functional Assessments, and Crisis and Risk Assessments, • Engage enrollees in care plan development and implementation, providing routine updates as the enrollee's status changes, • Lead the interdisciplinary care team (ICT) and collaborate with peers both internal and external to the organization, to create holistic care plans that address medical and non-medical needs., • Oversee enrollee utilization of long-term services and supports, ensuring appropriate systems are in place for enrollees to remain in the location of their choice, • Assist members in accessing community resources, including housing, transportation, food assistance, and social services., • Educate members about their benefits and available services under both Medicare and Medicaid., • Provide education to members and their families about managing chronic conditions, medication adherence, and preventive care., • Promote healthy lifestyle choices and self-management strategies., • Assist enrollees in preventative health strategies, including gap closure, • Follow up with members after hospitalizations or significant health events to ensure continuity of care and prevent readmissions., • Work closely with primary care physicians, specialists, and other healthcare providers to coordinate care and share relevant information., • Coordinate with community-based organizations, other stakeholders/entities, state agencies, and other service providers to ensure coordination and avoid duplication of services., • Advocate for the needs and preferences of enrollees within the healthcare system., • Evaluate member satisfaction through open communication and monitoring of concerns or issues., • Regular travel to conduct member, provider and community-based visits as required, • Report abuse, neglect, or exploitation of older adults and adults with disabilities as a mandated reporter as required by State law., • Adherence to NCQA and Care Management standards, • Performs any other job related duties as requested. Education and Experience: • Associates of Science (A.S) degree in nursing from an accredited nursing program required or, • Master's degree in social work or mental health counseling and independent license required, • Three (3) years of experience as a Registered Nurse/BH Clinician or, • One (1) year as a Registered Nurse/BH Clinician with two (2) years of experience working with people with complex medical, behavioral and social needs as an LPN, CHW, MA required, • Prior experience in care coordination, case management, or working with dual-eligible populations preferred, • Medicaid and/or Medicare managed care experience preferred Competencies, Knowledge and Skills: • Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel., • Understanding of Medicare and Medicaid programs, as well community resources and services available to dual-eligible beneficiaries., • Strong interpersonal and communication skills to effectively engage with members, families, and healthcare providers, • Ability to manage multiple cases and priorities while maintaining attention to detail., • Adhere to code of ethics that aligns with professional practice., • Awareness of and sensitivity to the diverse backgrounds and needs of the populations served, • Decision making and problem-solving skills., • Ability to function independently and effectively as part of an interdisciplinary team, • Strong and effective communication skills, both written and verbal, • Strong interpersonal and customer relations skills, • Strong customer service skills Licensure and Certification: • Current unrestricted clinical license in the Commonwealth of Massachusetts as a Registered Nurse (RN), Licensed Clinical Social Worker (LCSW), Licensed Independent Clinical Social Worker (LISCW), or a Licensed Mental Health Counselor (LMHC) required, • Case Management Certification is highly preferred, • Must have valid driver's license, vehicle and verifiable insurance. Employment in this position is conditional pending successful clearance of a driver's license record check. If the driver's license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in this position will be terminated, • To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 - March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified., • CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process. Working Conditions: • This is a mobile position, meaning that regular travel to different work locations, including homes, offices or other public settings, is essential. Will be exposed to weather conditions typical of the location and may be required to stand and/or sit for long periods of time. Must reside in the same territory they are assigned to work in; exceptions may be considered, due to business need May be required to travel greater than 50% of time to perform work duties. Required to use general office equipment, such as a telephone, photocopier, fax machine, and computer Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our members • Must live within commutable distance to the Commonwealth of Massachusetts, • Over 50% (Mobile) Routine travel required Compensation Range: $90,000 - $120,000 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type: Salary Competencies: • Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

Commonwealth Care Alliance (CCA) is a nonprofit, mission-driven health plan and care delivery organization designed for individuals with the most significant needs. As an affiliate of CareSource, a nationally recognized nonprofit managed care organization with over 2 million members across multiple states, CCA serves individuals enrolled in Medicaid and Medicare in Massachusetts through the Senior Care Options and One Care programs and its care delivery enterprises. CCA is dedicated to delivering comprehensive, integrated, and person-centered care, powered by its unique model of uncommon care, which yields improved quality outcomes and lower costs of care. Job Summary: The Clinical Care Manager-Massachusetts is a community based registered nurse responsible for providing monitoring, follow-up and clinical care management to dually-eligible enrollees with complex medical, behavioral and social care needs. This position focuses on integrating health services and community resources to coordinate enrollee care for improve health outcomes and enhanced quality of life. Essential Functions: • Engage with the enrollee in their homes and other community settings to establish an effective, complex care management relationship, while considering the cultural and linguistic needs of each member., • Function as a liaison between healthcare providers, community resources, and enrollees to ensure seamless communication and care transitions., • Perform required assessments on a timely basis, including but not limited to Comprehensive Assessment, MDS-HC (or successor) Functional Assessments, and Crisis and Risk Assessments, • Engage enrollees in care plan development and implementation, providing routine updates as the enrollee's status changes, • Lead the interdisciplinary care team (ICT) and collaborate with peers both internal and external to the organization, to create holistic care plans that address medical and non-medical needs., • Oversee enrollee utilization of long-term services and supports, ensuring appropriate systems are in place for enrollees to remain in the location of their choice, • Assist members in accessing community resources, including housing, transportation, food assistance, and social services., • Educate members about their benefits and available services under both Medicare and Medicaid., • Provide education to members and their families about managing chronic conditions, medication adherence, and preventive care., • Promote healthy lifestyle choices and self-management strategies., • Assist enrollees in preventative health strategies, including gap closure, • Follow up with members after hospitalizations or significant health events to ensure continuity of care and prevent readmissions., • Work closely with primary care physicians, specialists, and other healthcare providers to coordinate care and share relevant information., • Coordinate with community-based organizations, other stakeholders/entities, state agencies, and other service providers to ensure coordination and avoid duplication of services., • Advocate for the needs and preferences of enrollees within the healthcare system., • Evaluate member satisfaction through open communication and monitoring of concerns or issues., • Regular travel to conduct member, provider and community-based visits as required, • Report abuse, neglect, or exploitation of older adults and adults with disabilities as a mandated reporter as required by State law., • Adherence to NCQA and Care Management standards, • Performs any other job related duties as requested. Education and Experience: • Associates of Science (A.S) degree in nursing from an accredited nursing program required or, • Master's degree in social work or mental health counseling and independent license required, • Three (3) years of experience as a Registered Nurse/BH Clinician or, • One (1) year as a Registered Nurse/BH Clinician with two (2) years of experience working with people with complex medical, behavioral and social needs as an LPN, CHW, MA required, • Prior experience in care coordination, case management, or working with dual-eligible populations preferred, • Medicaid and/or Medicare managed care experience preferred Competencies, Knowledge and Skills:, • Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel., • Understanding of Medicare and Medicaid programs, as well community resources and services available to dual-eligible beneficiaries., • Strong interpersonal and communication skills to effectively engage with members, families, and healthcare providers, • Ability to manage multiple cases and priorities while maintaining attention to detail., • Adhere to code of ethics that aligns with professional practice., • Awareness of and sensitivity to the diverse backgrounds and needs of the populations served, • Decision making and problem-solving skills., • Ability to function independently and effectively as part of an interdisciplinary team, • Strong and effective communication skills, both written and verbal, • Strong interpersonal and customer relations skills, • Strong customer service skillsLicensure and Certification:, • Current unrestricted clinical license in the Commonwealth of Massachusetts as a Registered Nurse (RN), Licensed Clinical Social Worker (LCSW), Licensed Independent Clinical Social Worker (LISCW), or a Licensed Mental Health Counselor (LMHC) required, • Case Management Certification is highly preferred, • Must have valid driver's license, vehicle and verifiable insurance. Employment in this position is conditional pending successful clearance of a driver's license record check. If the driver's license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in this position will be terminated, • To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 - March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified., • CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process.Working Conditions:, • This is a mobile position, meaning that regular travel to different work locations, including homes, offices or other public settings, is essential. Will be exposed to weather conditions typical of the location and may be required to stand and/or sit for long periods of time. Must reside in the same territory they are assigned to work in; exceptions may be considered, due to business need May be required to travel greater than 50% of time to perform work duties. Required to use general office equipment, such as a telephone, photocopier, fax machine, and computer Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our members, • Must live within commutable distance to the Commonwealth of Massachusetts, • Over 50% (Mobile) Routine travel required Compensation Range: $90,000 - $120,000 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type: Salary Competencies: • Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

Commonwealth Care Alliance (CCA) is a nonprofit, mission-driven health plan and care delivery organization designed for individuals with the most significant needs. As an affiliate of CareSource, a nationally recognized nonprofit managed care organization with over 2 million members across multiple states, CCA serves individuals enrolled in Medicaid and Medicare in Massachusetts through the Senior Care Options and One Care programs and its care delivery enterprises. CCA is dedicated to delivering comprehensive, integrated, and person-centered care, powered by its unique model of uncommon care, which yields improved quality outcomes and lower costs of care. Job Summary: The Clinical Care Manager-Massachusetts is a community based registered nurse responsible for providing monitoring, follow-up and clinical care management to dually-eligible enrollees with complex medical, behavioral and social care needs. This position focuses on integrating health services and community resources to coordinate enrollee care for improve health outcomes and enhanced quality of life. Essential Functions: • Engage with the enrollee in their homes and other community settings to establish an effective, complex care management relationship, while considering the cultural and linguistic needs of each member., • Function as a liaison between healthcare providers, community resources, and enrollees to ensure seamless communication and care transitions., • Perform required assessments on a timely basis, including but not limited to Comprehensive Assessment, MDS-HC (or successor) Functional Assessments, and Crisis and Risk Assessments, • Engage enrollees in care plan development and implementation, providing routine updates as the enrollee's status changes, • Lead the interdisciplinary care team (ICT) and collaborate with peers both internal and external to the organization, to create holistic care plans that address medical and non-medical needs., • Oversee enrollee utilization of long-term services and supports, ensuring appropriate systems are in place for enrollees to remain in the location of their choice, • Assist members in accessing community resources, including housing, transportation, food assistance, and social services., • Educate members about their benefits and available services under both Medicare and Medicaid., • Provide education to members and their families about managing chronic conditions, medication adherence, and preventive care., • Promote healthy lifestyle choices and self-management strategies., • Assist enrollees in preventative health strategies, including gap closure, • Follow up with members after hospitalizations or significant health events to ensure continuity of care and prevent readmissions., • Work closely with primary care physicians, specialists, and other healthcare providers to coordinate care and share relevant information., • Coordinate with community-based organizations, other stakeholders/entities, state agencies, and other service providers to ensure coordination and avoid duplication of services., • Advocate for the needs and preferences of enrollees within the healthcare system., • Evaluate member satisfaction through open communication and monitoring of concerns or issues., • Regular travel to conduct member, provider and community-based visits as required, • Report abuse, neglect, or exploitation of older adults and adults with disabilities as a mandated reporter as required by State law., • Adherence to NCQA and Care Management standards, • Performs any other job related duties as requested. Education and Experience: • Associates of Science (A.S) degree in nursing from an accredited nursing program required or, • Master's degree in social work or mental health counseling and independent license required, • Three (3) years of experience as a Registered Nurse/BH Clinician or, • One (1) year as a Registered Nurse/BH Clinician with two (2) years of experience working with people with complex medical, behavioral and social needs as an LPN, CHW, MA required, • Prior experience in care coordination, case management, or working with dual-eligible populations preferred, • Medicaid and/or Medicare managed care experience preferred Competencies, Knowledge and Skills: • Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel., • Understanding of Medicare and Medicaid programs, as well community resources and services available to dual-eligible beneficiaries., • Strong interpersonal and communication skills to effectively engage with members, families, and healthcare providers, • Ability to manage multiple cases and priorities while maintaining attention to detail., • Adhere to code of ethics that aligns with professional practice., • Awareness of and sensitivity to the diverse backgrounds and needs of the populations served, • Decision making and problem-solving skills., • Ability to function independently and effectively as part of an interdisciplinary team, • Strong and effective communication skills, both written and verbal, • Strong interpersonal and customer relations skills, • Strong customer service skills Licensure and Certification: • Current unrestricted clinical license in the Commonwealth of Massachusetts as a Registered Nurse (RN), Licensed Clinical Social Worker (LCSW), Licensed Independent Clinical Social Worker (LISCW), or a Licensed Mental Health Counselor (LMHC) required, • Case Management Certification is highly preferred, • Must have valid driver's license, vehicle and verifiable insurance. Employment in this position is conditional pending successful clearance of a driver's license record check. If the driver's license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in this position will be terminated, • To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 - March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified., • CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process. Working Conditions: • This is a mobile position, meaning that regular travel to different work locations, including homes, offices or other public settings, is essential. Will be exposed to weather conditions typical of the location and may be required to stand and/or sit for long periods of time. Must reside in the same territory they are assigned to work in; exceptions may be considered, due to business need May be required to travel greater than 50% of time to perform work duties. Required to use general office equipment, such as a telephone, photocopier, fax machine, and computer Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our members • Must live within commutable distance to the Commonwealth of Massachusetts, • Over 50% (Mobile) Routine travel required Compensation Range: $90,000 - $120,000 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type: Salary Competencies: • Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

Every Saturday 8:30am-4:00pm The Care Transition Specialist completes administrative responsibilities related to care progression and care transitions along the continuum of care. They work collaboratively with nurse care coordinators, social workers, physicians, and other care team members. The Care Transition Specialist is responsible for acting as an advocate for patients and patient families and strives to support Newton Wellesley Hospital's aim for high quality care, high customer satisfaction, and optimal resource management. Essential Functions: 1. Provides direct administrative support to the care team, patients, and patients' caregivers: -Support the administrative tasks and communication related to post discharge care (e.g., the 4Next process, faxing to long term care facilities, follow-up appointments, etc.). -Performs administrative tasks to support the ordering of equipment, completion of forms, and medication authorizations. -Distributes key forms and documents to comply with regulations (e.g., MOON, IM, etc.). -Arranges all types of patient transportation under the direction of the care team. -May participate in family meetings and interdisciplinary huddles to solicit and provide input related to their responsibilities. -Completes administrative documentation under the direction of the care team. 2. Collects, confirms, and verifies key patient information (i.e., demographics, health care proxy, benefit verification, and patient preferences for pharmacy, VNA, etc.) 3. Maintains knowledge and reference materials on key resources available to patients and patients' caregivers across the continuum: -Acts as a knowledge resource for post-acute care resources, included but not limited to, insurance requirements, facility attributes, contact information, etc. -Identifies and refers patients to community services (i.e., transportation, food programs, day programs, and financial programs) -Communicates, consults, and collaborates with a wide range of social agencies, clinics, schools, and courts under the direction of the care team Education: • High School Degree or GED required., • Associate's Degree or Bachelor's Degree preferred and health care experience, preferably in extended care facilities and community agencies., • Preferred experience in hospital discharge planning, long term care facility, community health or utilization review. Job Knowledge and Skills: • Interpersonal skills to interact effectively with various levels of staff, patients, families and community organizations., • Must be able to participate effectively in an interdisciplinary team setting., • Extensive knowledge of regulations, community organization, state and federal systems, medical terminology andlevels of health care., • Must be able to manage a variable workload with the ability to constantly change priorities. Requires ability to work proactively and independently., • Requires basic typing and/or computer data entry skills, experience with personal computer and software desirable., • Must be very flexible in a constantly changing environment. Newton-Wellesley Hospital 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.

Commonwealth Care Alliance (CCA) is a nonprofit, mission-driven health plan and care delivery organization designed for individuals with the most significant needs. As an affiliate of CareSource, a nationally recognized nonprofit managed care organization with over 2 million members across multiple states, CCA serves individuals enrolled in Medicaid and Medicare in Massachusetts through the Senior Care Options and One Care programs and its care delivery enterprises. CCA is dedicated to delivering comprehensive, integrated, and person-centered care, powered by its unique model of uncommon care, which yields improved quality outcomes and lower costs of care. Job Summary: The Clinical Care Manager-Massachusetts is a community based registered nurse responsible for providing monitoring, follow-up and clinical care management to dually-eligible enrollees with complex medical, behavioral and social care needs. This position focuses on integrating health services and community resources to coordinate enrollee care for improve health outcomes and enhanced quality of life. Essential Functions: • Engage with the enrollee in their homes and other community settings to establish an effective, complex care management relationship, while considering the cultural and linguistic needs of each member., • Function as a liaison between healthcare providers, community resources, and enrollees to ensure seamless communication and care transitions., • Perform required assessments on a timely basis, including but not limited to Comprehensive Assessment, MDS-HC (or successor) Functional Assessments, and Crisis and Risk Assessments, • Engage enrollees in care plan development and implementation, providing routine updates as the enrollee's status changes, • Lead the interdisciplinary care team (ICT) and collaborate with peers both internal and external to the organization, to create holistic care plans that address medical and non-medical needs., • Oversee enrollee utilization of long-term services and supports, ensuring appropriate systems are in place for enrollees to remain in the location of their choice, • Assist members in accessing community resources, including housing, transportation, food assistance, and social services., • Educate members about their benefits and available services under both Medicare and Medicaid., • Provide education to members and their families about managing chronic conditions, medication adherence, and preventive care., • Promote healthy lifestyle choices and self-management strategies., • Assist enrollees in preventative health strategies, including gap closure, • Follow up with members after hospitalizations or significant health events to ensure continuity of care and prevent readmissions., • Work closely with primary care physicians, specialists, and other healthcare providers to coordinate care and share relevant information., • Coordinate with community-based organizations, other stakeholders/entities, state agencies, and other service providers to ensure coordination and avoid duplication of services., • Advocate for the needs and preferences of enrollees within the healthcare system., • Evaluate member satisfaction through open communication and monitoring of concerns or issues., • Regular travel to conduct member, provider and community-based visits as required, • Report abuse, neglect, or exploitation of older adults and adults with disabilities as a mandated reporter as required by State law., • Adherence to NCQA and Care Management standards, • Performs any other job related duties as requested. Education and Experience: • Associates of Science (A.S) degree in nursing from an accredited nursing program required or, • Master's degree in social work or mental health counseling and independent license required, • Three (3) years of experience as a Registered Nurse/BH Clinician or, • One (1) year as a Registered Nurse/BH Clinician with two (2) years of experience working with people with complex medical, behavioral and social needs as an LPN, CHW, MA required, • Prior experience in care coordination, case management, or working with dual-eligible populations preferred, • Medicaid and/or Medicare managed care experience preferred Competencies, Knowledge and Skills:, • Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel., • Understanding of Medicare and Medicaid programs, as well community resources and services available to dual-eligible beneficiaries., • Strong interpersonal and communication skills to effectively engage with members, families, and healthcare providers, • Ability to manage multiple cases and priorities while maintaining attention to detail., • Adhere to code of ethics that aligns with professional practice., • Awareness of and sensitivity to the diverse backgrounds and needs of the populations served, • Decision making and problem-solving skills., • Ability to function independently and effectively as part of an interdisciplinary team, • Strong and effective communication skills, both written and verbal, • Strong interpersonal and customer relations skills, • Strong customer service skillsLicensure and Certification:, • Current unrestricted clinical license in the Commonwealth of Massachusetts as a Registered Nurse (RN), Licensed Clinical Social Worker (LCSW), Licensed Independent Clinical Social Worker (LISCW), or a Licensed Mental Health Counselor (LMHC) required, • Case Management Certification is highly preferred, • Must have valid driver's license, vehicle and verifiable insurance. Employment in this position is conditional pending successful clearance of a driver's license record check. If the driver's license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in this position will be terminated, • To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 - March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified., • CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process.Working Conditions:, • This is a mobile position, meaning that regular travel to different work locations, including homes, offices or other public settings, is essential. Will be exposed to weather conditions typical of the location and may be required to stand and/or sit for long periods of time. Must reside in the same territory they are assigned to work in; exceptions may be considered, due to business need May be required to travel greater than 50% of time to perform work duties. Required to use general office equipment, such as a telephone, photocopier, fax machine, and computer Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our members, • Must live within commutable distance to the Commonwealth of Massachusetts, • Over 50% (Mobile) Routine travel required Compensation Range: $90,000 - $120,000 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type: Salary Competencies: • Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

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. Does this position require Patient Care? Yes 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. 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] - required Basic Life Support [BLS Certification] - 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. 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 - 35lbs, • Pushing 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%) The Spaulding Rehabilitation Hospital Corporation 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.

$20K sign on bonus Mon-Fri 3:00-11:30pm Work Life Balance: Flexible evening shifts available Commuting: 50% MBTA Discount, or parking options 20K sign on We're offering a generous sign-on bonus to welcome you to our team. Recognizing and valuing exceptional talent, we're eager to discuss the exciting details of this bonus during our interview process. Medical, Dental & Vision insurance: Starts day 1 PTO: up to 30 days annually for new hires including hospital holidays Retirement: A hospital funded pension plus a 403(b) with company match * Career Growth: Opportunities for growth within divisions as well as advancement into other modalities Summary Under general supervision, the MRI technologist will safely perform magnetic resonance imaging (MRI) studies using a magnetic resonance imaging system. The scope of the MRI technologist includes preparing patients, positioning, setting imaging parameters, acquiring images, performing computer processing, and displaying images. The MRI technologist selects appropriate imaging protocols for patient studies and performs quality assurance scans as required. The MRI technologist demonstrates the ability to work cohesively as a team member within the MRI Department and consults appropriate content experts as needed. (i.e., radiologist, nurse, child life specialist) Staff must demonstrate the ability to rotate to MRI scanners across the assigned department as needed. MRI Registered Technologist with ARRT or ARMRIT required within one year of hire. Does this position require Patient Care? Yes Essential Functions -Verify patient identity and exam details in compliance with Joint Commission standards. -Conduct MRI scans for ambulatory/outpatient patients, including image acquisition and processing, while maintaining diagnostic quality. -Safely perform IV insertions and contrast injections, monitor for adverse reactions, and document procedures in the EMR. -Educate patients and visitors on MRI safety, enforce safety protocols, and respond to equipment-related emergencies. -Perform scheduled quality control checks on MRI equipment and report issues as needed. -Assist with administrative and logistical tasks such as scheduling, patient transport, inventory, and filing. Education Other Certificate/Diploma Medical Imaging required or Associate's Degree Medical Imaging preferred Can this role accept experience in lieu of a degree? No Licenses and Credentials Magnetic Resonance Imaging [R.T.(MR)(ARRT)] - American Registry of Radiologic Technologists (ARRT) OR American Registry of Magnetic Resonance Imaging Technologists (ARMRIT) required within one year Experience MRI Tech experience with multiple patient populations 0-1 year required Knowledge, Skills and Abilities • Ability to operate complex electronic equipment and instrumentation and perform quality control procedures where appropriate., • Ability to transfer patients to the MRI scan table and push the table from the prep room to the exam room; must lift and transfer patients to stretchers., • Must demonstrate the ability to provide appropriate care to various age populations. In addition, may oversee students within the department and may be required to work with lab animals for research purposes., • Maintains ethical standards (patient confidentiality, professional conduct, etc.)., • Utilizes departmental-specific tools to confirm contrast dosing and patient safety. These tools include the EMR MRI search engine, electronic dose calculators, image review systems (PACS), and other means designated by the department., • Works collaboratively with the local MRI leadership team to ensure smooth efficient patient flow and optimal utilization of the MRI scanners. Maintains effective working relationships and communication with all departmental staff and other hospital personnel. The General Hospital Corporation 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.

Commonwealth Care Alliance (CCA) is a nonprofit, mission-driven health plan and care delivery organization designed for individuals with the most significant needs. As an affiliate of CareSource, a nationally recognized nonprofit managed care organization with over 2 million members across multiple states, CCA serves individuals enrolled in Medicaid and Medicare in Massachusetts through the Senior Care Options and One Care programs and its care delivery enterprises. CCA is dedicated to delivering comprehensive, integrated, and person-centered care, powered by its unique model of uncommon care, which yields improved quality outcomes and lower costs of care. Job Summary: The Clinical Care Manager-Massachusetts is a community based registered nurse responsible for providing monitoring, follow-up and clinical care management to dually-eligible enrollees with complex medical, behavioral and social care needs. This position focuses on integrating health services and community resources to coordinate enrollee care for improve health outcomes and enhanced quality of life. Essential Functions: • Engage with the enrollee in their homes and other community settings to establish an effective, complex care management relationship, while considering the cultural and linguistic needs of each member., • Function as a liaison between healthcare providers, community resources, and enrollees to ensure seamless communication and care transitions., • Perform required assessments on a timely basis, including but not limited to Comprehensive Assessment, MDS-HC (or successor) Functional Assessments, and Crisis and Risk Assessments, • Engage enrollees in care plan development and implementation, providing routine updates as the enrollee's status changes, • Lead the interdisciplinary care team (ICT) and collaborate with peers both internal and external to the organization, to create holistic care plans that address medical and non-medical needs., • Oversee enrollee utilization of long-term services and supports, ensuring appropriate systems are in place for enrollees to remain in the location of their choice, • Assist members in accessing community resources, including housing, transportation, food assistance, and social services., • Educate members about their benefits and available services under both Medicare and Medicaid., • Provide education to members and their families about managing chronic conditions, medication adherence, and preventive care., • Promote healthy lifestyle choices and self-management strategies., • Assist enrollees in preventative health strategies, including gap closure, • Follow up with members after hospitalizations or significant health events to ensure continuity of care and prevent readmissions., • Work closely with primary care physicians, specialists, and other healthcare providers to coordinate care and share relevant information., • Coordinate with community-based organizations, other stakeholders/entities, state agencies, and other service providers to ensure coordination and avoid duplication of services., • Advocate for the needs and preferences of enrollees within the healthcare system., • Evaluate member satisfaction through open communication and monitoring of concerns or issues., • Regular travel to conduct member, provider and community-based visits as required, • Report abuse, neglect, or exploitation of older adults and adults with disabilities as a mandated reporter as required by State law., • Adherence to NCQA and Care Management standards, • Performs any other job related duties as requested. Education and Experience: • Associates of Science (A.S) degree in nursing from an accredited nursing program required or, • Master's degree in social work or mental health counseling and independent license required, • Three (3) years of experience as a Registered Nurse/BH Clinician or, • One (1) year as a Registered Nurse/BH Clinician with two (2) years of experience working with people with complex medical, behavioral and social needs as an LPN, CHW, MA required, • Prior experience in care coordination, case management, or working with dual-eligible populations preferred, • Medicaid and/or Medicare managed care experience preferred Competencies, Knowledge and Skills:, • Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel., • Understanding of Medicare and Medicaid programs, as well community resources and services available to dual-eligible beneficiaries., • Strong interpersonal and communication skills to effectively engage with members, families, and healthcare providers, • Ability to manage multiple cases and priorities while maintaining attention to detail., • Adhere to code of ethics that aligns with professional practice., • Awareness of and sensitivity to the diverse backgrounds and needs of the populations served, • Decision making and problem-solving skills., • Ability to function independently and effectively as part of an interdisciplinary team, • Strong and effective communication skills, both written and verbal, • Strong interpersonal and customer relations skills, • Strong customer service skillsLicensure and Certification:, • Current unrestricted clinical license in the Commonwealth of Massachusetts as a Registered Nurse (RN), Licensed Clinical Social Worker (LCSW), Licensed Independent Clinical Social Worker (LISCW), or a Licensed Mental Health Counselor (LMHC) required, • Case Management Certification is highly preferred, • Must have valid driver's license, vehicle and verifiable insurance. Employment in this position is conditional pending successful clearance of a driver's license record check. If the driver's license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in this position will be terminated, • To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 - March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified., • CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process.Working Conditions:, • This is a mobile position, meaning that regular travel to different work locations, including homes, offices or other public settings, is essential. Will be exposed to weather conditions typical of the location and may be required to stand and/or sit for long periods of time. Must reside in the same territory they are assigned to work in; exceptions may be considered, due to business need May be required to travel greater than 50% of time to perform work duties. Required to use general office equipment, such as a telephone, photocopier, fax machine, and computer Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our members, • Must live within commutable distance to the Commonwealth of Massachusetts, • Over 50% (Mobile) Routine travel required Compensation Range: $90,000 - $120,000 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type: Salary Competencies: • Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

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 the program's eligibility requirements and those of the 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. Does this position require Patient Care? Yes 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 as needed to discuss challenging cases. > -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. 5 - 8 hour shifts with one weekend commitment a month 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 MA Registered Nurse License 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. The General Hospital Corporation 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.

The RN Case Manager serves as a core member of the care team by coordinating and supporting healthcare within the facility and coordinating referrals for services outside the clinic. The RN provides outreach and enrollment services to meet eligibility requirements of the program and surrounding counties, and ensures coordination and planning, including community and family support, by focusing on the development and coordination of community service plans and partnering with service providers, families, and patients to create a plan of healthcare. Primary Responsibilities: - Conduct client assessments and planning. - Modify patient treatment plans as indicated by patients' responses and conditions. - Prepare patient/family for discharge. - Communicate with third party payers to obtain necessary authorization for reimbursement of services. - Define care goals of patients by providing education, information, and direction to each individual and family. - Review cases with medical directors on challenging cases as needed. - Maintain accurate, detailed reports and records. What You'll Bring Qualifications: • Associate's Degree Nursing required (Bachelor's Degree Nursing preferred)., • Active and unrestricted Registered Nurse (RN) Licensure for the state of Massachusetts required., • 2+ years of case management and/or discharge planning required., • Experience working with complex dually eligible populations required., • Knowledge of Managed Care preferred., • Understanding of diagnostic criteria for dual conditions and the ability to conceptualize modalities and placement criteria within the continuum of care preferred., • Utilization Review experience preferred. Additional 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. Schedule and Working Model • Full-time, Monday through Friday, approximately 8:30am-5pm., • Hybrid: Approximately 2 days per week in the field and 3 days per week at home, with flexibility as needed. Mass General Brigham Community Physicians, Inc. 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.

Commonwealth Care Alliance (CCA) is a nonprofit, mission-driven health plan and care delivery organization designed for individuals with the most significant needs. As an affiliate of CareSource, a nationally recognized nonprofit managed care organization with over 2 million members across multiple states, CCA serves individuals enrolled in Medicaid and Medicare in Massachusetts through the Senior Care Options and One Care programs and its care delivery enterprises. CCA is dedicated to delivering comprehensive, integrated, and person-centered care, powered by its unique model of uncommon care, which yields improved quality outcomes and lower costs of care. Job Summary: The Clinical Care Manager-Massachusetts is a community based registered nurse responsible for providing monitoring, follow-up and clinical care management to dually-eligible enrollees with complex medical, behavioral and social care needs. This position focuses on integrating health services and community resources to coordinate enrollee care for improve health outcomes and enhanced quality of life. Essential Functions: • Engage with the enrollee in their homes and other community settings to establish an effective, complex care management relationship, while considering the cultural and linguistic needs of each member., • Function as a liaison between healthcare providers, community resources, and enrollees to ensure seamless communication and care transitions., • Perform required assessments on a timely basis, including but not limited to Comprehensive Assessment, MDS-HC (or successor) Functional Assessments, and Crisis and Risk Assessments, • Engage enrollees in care plan development and implementation, providing routine updates as the enrollee's status changes, • Lead the interdisciplinary care team (ICT) and collaborate with peers both internal and external to the organization, to create holistic care plans that address medical and non-medical needs., • Oversee enrollee utilization of long-term services and supports, ensuring appropriate systems are in place for enrollees to remain in the location of their choice, • Assist members in accessing community resources, including housing, transportation, food assistance, and social services., • Educate members about their benefits and available services under both Medicare and Medicaid., • Provide education to members and their families about managing chronic conditions, medication adherence, and preventive care., • Promote healthy lifestyle choices and self-management strategies., • Assist enrollees in preventative health strategies, including gap closure, • Follow up with members after hospitalizations or significant health events to ensure continuity of care and prevent readmissions., • Work closely with primary care physicians, specialists, and other healthcare providers to coordinate care and share relevant information., • Coordinate with community-based organizations, other stakeholders/entities, state agencies, and other service providers to ensure coordination and avoid duplication of services., • Advocate for the needs and preferences of enrollees within the healthcare system., • Evaluate member satisfaction through open communication and monitoring of concerns or issues., • Regular travel to conduct member, provider and community-based visits as required, • Report abuse, neglect, or exploitation of older adults and adults with disabilities as a mandated reporter as required by State law., • Adherence to NCQA and Care Management standards, • Performs any other job related duties as requested. Education and Experience: • Associates of Science (A.S) degree in nursing from an accredited nursing program required or, • Master's degree in social work or mental health counseling and independent license required, • Three (3) years of experience as a Registered Nurse/BH Clinician or, • One (1) year as a Registered Nurse/BH Clinician with two (2) years of experience working with people with complex medical, behavioral and social needs as an LPN, CHW, MA required, • Prior experience in care coordination, case management, or working with dual-eligible populations preferred, • Medicaid and/or Medicare managed care experience preferred Competencies, Knowledge and Skills:, • Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel., • Understanding of Medicare and Medicaid programs, as well community resources and services available to dual-eligible beneficiaries., • Strong interpersonal and communication skills to effectively engage with members, families, and healthcare providers, • Ability to manage multiple cases and priorities while maintaining attention to detail., • Adhere to code of ethics that aligns with professional practice., • Awareness of and sensitivity to the diverse backgrounds and needs of the populations served, • Decision making and problem-solving skills., • Ability to function independently and effectively as part of an interdisciplinary team, • Strong and effective communication skills, both written and verbal, • Strong interpersonal and customer relations skills, • Strong customer service skillsLicensure and Certification:, • Current unrestricted clinical license in the Commonwealth of Massachusetts as a Registered Nurse (RN), Licensed Clinical Social Worker (LCSW), Licensed Independent Clinical Social Worker (LISCW), or a Licensed Mental Health Counselor (LMHC) required, • Case Management Certification is highly preferred, • Must have valid driver's license, vehicle and verifiable insurance. Employment in this position is conditional pending successful clearance of a driver's license record check. If the driver's license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in this position will be terminated, • To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 - March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified., • CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process.Working Conditions:, • This is a mobile position, meaning that regular travel to different work locations, including homes, offices or other public settings, is essential. Will be exposed to weather conditions typical of the location and may be required to stand and/or sit for long periods of time. Must reside in the same territory they are assigned to work in; exceptions may be considered, due to business need May be required to travel greater than 50% of time to perform work duties. Required to use general office equipment, such as a telephone, photocopier, fax machine, and computer Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our members, • Must live within commutable distance to the Commonwealth of Massachusetts, • Over 50% (Mobile) Routine travel required Compensation Range: $90,000 - $120,000 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type: Salary Competencies: • Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

Commonwealth Care Alliance (CCA) is a nonprofit, mission-driven health plan and care delivery organization designed for individuals with the most significant needs. As an affiliate of CareSource, a nationally recognized nonprofit managed care organization with over 2 million members across multiple states, CCA serves individuals enrolled in Medicaid and Medicare in Massachusetts through the Senior Care Options and One Care programs and its care delivery enterprises. CCA is dedicated to delivering comprehensive, integrated, and person-centered care, powered by its unique model of uncommon care, which yields improved quality outcomes and lower costs of care. Job Summary: The Clinical Care Manager-Massachusetts is a community based registered nurse responsible for providing monitoring, follow-up and clinical care management to dually-eligible enrollees with complex medical, behavioral and social care needs. This position focuses on integrating health services and community resources to coordinate enrollee care for improve health outcomes and enhanced quality of life. Essential Functions: • Engage with the enrollee in their homes and other community settings to establish an effective, complex care management relationship, while considering the cultural and linguistic needs of each member., • Function as a liaison between healthcare providers, community resources, and enrollees to ensure seamless communication and care transitions., • Perform required assessments on a timely basis, including but not limited to Comprehensive Assessment, MDS-HC (or successor) Functional Assessments, and Crisis and Risk Assessments, • Engage enrollees in care plan development and implementation, providing routine updates as the enrollee's status changes, • Lead the interdisciplinary care team (ICT) and collaborate with peers both internal and external to the organization, to create holistic care plans that address medical and non-medical needs., • Oversee enrollee utilization of long-term services and supports, ensuring appropriate systems are in place for enrollees to remain in the location of their choice, • Assist members in accessing community resources, including housing, transportation, food assistance, and social services., • Educate members about their benefits and available services under both Medicare and Medicaid., • Provide education to members and their families about managing chronic conditions, medication adherence, and preventive care., • Promote healthy lifestyle choices and self-management strategies., • Assist enrollees in preventative health strategies, including gap closure, • Follow up with members after hospitalizations or significant health events to ensure continuity of care and prevent readmissions., • Work closely with primary care physicians, specialists, and other healthcare providers to coordinate care and share relevant information., • Coordinate with community-based organizations, other stakeholders/entities, state agencies, and other service providers to ensure coordination and avoid duplication of services., • Advocate for the needs and preferences of enrollees within the healthcare system., • Evaluate member satisfaction through open communication and monitoring of concerns or issues., • Regular travel to conduct member, provider and community-based visits as required, • Report abuse, neglect, or exploitation of older adults and adults with disabilities as a mandated reporter as required by State law., • Adherence to NCQA and Care Management standards, • Performs any other job related duties as requested. Education and Experience: • Associates of Science (A.S) degree in nursing from an accredited nursing program required or, • Master's degree in social work or mental health counseling and independent license required, • Three (3) years of experience as a Registered Nurse/BH Clinician or, • One (1) year as a Registered Nurse/BH Clinician with two (2) years of experience working with people with complex medical, behavioral and social needs as an LPN, CHW, MA required, • Prior experience in care coordination, case management, or working with dual-eligible populations preferred, • Medicaid and/or Medicare managed care experience preferred Competencies, Knowledge and Skills:, • Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel., • Understanding of Medicare and Medicaid programs, as well community resources and services available to dual-eligible beneficiaries., • Strong interpersonal and communication skills to effectively engage with members, families, and healthcare providers, • Ability to manage multiple cases and priorities while maintaining attention to detail., • Adhere to code of ethics that aligns with professional practice., • Awareness of and sensitivity to the diverse backgrounds and needs of the populations served, • Decision making and problem-solving skills., • Ability to function independently and effectively as part of an interdisciplinary team, • Strong and effective communication skills, both written and verbal, • Strong interpersonal and customer relations skills, • Strong customer service skillsLicensure and Certification:, • Current unrestricted clinical license in the Commonwealth of Massachusetts as a Registered Nurse (RN), Licensed Clinical Social Worker (LCSW), Licensed Independent Clinical Social Worker (LISCW), or a Licensed Mental Health Counselor (LMHC) required, • Case Management Certification is highly preferred, • Must have valid driver's license, vehicle and verifiable insurance. Employment in this position is conditional pending successful clearance of a driver's license record check. If the driver's license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in this position will be terminated, • To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 - March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified., • CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process.Working Conditions:, • This is a mobile position, meaning that regular travel to different work locations, including homes, offices or other public settings, is essential. Will be exposed to weather conditions typical of the location and may be required to stand and/or sit for long periods of time. Must reside in the same territory they are assigned to work in; exceptions may be considered, due to business need May be required to travel greater than 50% of time to perform work duties. Required to use general office equipment, such as a telephone, photocopier, fax machine, and computer Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our members, • Must live within commutable distance to the Commonwealth of Massachusetts, • Over 50% (Mobile) Routine travel required Compensation Range: $90,000 - $120,000 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type: Salary Competencies: • Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds. #LI-KG1

Commonwealth Care Alliance (CCA) is a nonprofit, mission-driven health plan and care delivery organization designed for individuals with the most significant needs. As an affiliate of CareSource, a nationally recognized nonprofit managed care organization with over 2 million members across multiple states, CCA serves individuals enrolled in Medicaid and Medicare in Massachusetts through the Senior Care Options and One Care programs and its care delivery enterprises. CCA is dedicated to delivering comprehensive, integrated, and person-centered care, powered by its unique model of uncommon care, which yields improved quality outcomes and lower costs of care. Job Summary: The Clinical Care Manager-Massachusetts is a community based registered nurse responsible for providing monitoring, follow-up and clinical care management to dually-eligible enrollees with complex medical, behavioral and social care needs. This position focuses on integrating health services and community resources to coordinate enrollee care for improve health outcomes and enhanced quality of life. Essential Functions: • Engage with the enrollee in their homes and other community settings to establish an effective, complex care management relationship, while considering the cultural and linguistic needs of each member., • Function as a liaison between healthcare providers, community resources, and enrollees to ensure seamless communication and care transitions., • Perform required assessments on a timely basis, including but not limited to Comprehensive Assessment, MDS-HC (or successor) Functional Assessments, and Crisis and Risk Assessments, • Engage enrollees in care plan development and implementation, providing routine updates as the enrollee's status changes, • Lead the interdisciplinary care team (ICT) and collaborate with peers both internal and external to the organization, to create holistic care plans that address medical and non-medical needs., • Oversee enrollee utilization of long-term services and supports, ensuring appropriate systems are in place for enrollees to remain in the location of their choice, • Assist members in accessing community resources, including housing, transportation, food assistance, and social services., • Educate members about their benefits and available services under both Medicare and Medicaid., • Provide education to members and their families about managing chronic conditions, medication adherence, and preventive care., • Promote healthy lifestyle choices and self-management strategies., • Assist enrollees in preventative health strategies, including gap closure, • Follow up with members after hospitalizations or significant health events to ensure continuity of care and prevent readmissions., • Work closely with primary care physicians, specialists, and other healthcare providers to coordinate care and share relevant information., • Coordinate with community-based organizations, other stakeholders/entities, state agencies, and other service providers to ensure coordination and avoid duplication of services., • Advocate for the needs and preferences of enrollees within the healthcare system., • Evaluate member satisfaction through open communication and monitoring of concerns or issues., • Regular travel to conduct member, provider and community-based visits as required, • Report abuse, neglect, or exploitation of older adults and adults with disabilities as a mandated reporter as required by State law., • Adherence to NCQA and Care Management standards, • Performs any other job related duties as requested. Education and Experience: • Associates of Science (A.S) degree in nursing from an accredited nursing program required or, • Master's degree in social work or mental health counseling and independent license required, • Three (3) years of experience as a Registered Nurse/BH Clinician or, • One (1) year as a Registered Nurse/BH Clinician with two (2) years of experience working with people with complex medical, behavioral and social needs as an LPN, CHW, MA required, • Prior experience in care coordination, case management, or working with dual-eligible populations preferred, • Medicaid and/or Medicare managed care experience preferred Competencies, Knowledge and Skills:, • Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel., • Understanding of Medicare and Medicaid programs, as well community resources and services available to dual-eligible beneficiaries., • Strong interpersonal and communication skills to effectively engage with members, families, and healthcare providers, • Ability to manage multiple cases and priorities while maintaining attention to detail., • Adhere to code of ethics that aligns with professional practice., • Awareness of and sensitivity to the diverse backgrounds and needs of the populations served, • Decision making and problem-solving skills., • Ability to function independently and effectively as part of an interdisciplinary team, • Strong and effective communication skills, both written and verbal, • Strong interpersonal and customer relations skills, • Strong customer service skillsLicensure and Certification:, • Current unrestricted clinical license in the Commonwealth of Massachusetts as a Registered Nurse (RN), Licensed Clinical Social Worker (LCSW), Licensed Independent Clinical Social Worker (LISCW), or a Licensed Mental Health Counselor (LMHC) required, • Case Management Certification is highly preferred, • Must have valid driver's license, vehicle and verifiable insurance. Employment in this position is conditional pending successful clearance of a driver's license record check. If the driver's license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in this position will be terminated, • To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 - March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified., • CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process.Working Conditions:, • This is a mobile position, meaning that regular travel to different work locations, including homes, offices or other public settings, is essential. Will be exposed to weather conditions typical of the location and may be required to stand and/or sit for long periods of time. Must reside in the same territory they are assigned to work in; exceptions may be considered, due to business need May be required to travel greater than 50% of time to perform work duties. Required to use general office equipment, such as a telephone, photocopier, fax machine, and computer Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our members, • Must live within commutable distance to the Commonwealth of Massachusetts, • Over 50% (Mobile) Routine travel required Compensation Range: $90,000 - $120,000 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type: Salary Competencies: • Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

Commonwealth Care Alliance (CCA) is a nonprofit, mission-driven health plan and care delivery organization designed for individuals with the most significant needs. As an affiliate of CareSource, a nationally recognized nonprofit managed care organization with over 2 million members across multiple states, CCA serves individuals enrolled in Medicaid and Medicare in Massachusetts through the Senior Care Options and One Care programs and its care delivery enterprises. CCA is dedicated to delivering comprehensive, integrated, and person-centered care, powered by its unique model of uncommon care, which yields improved quality outcomes and lower costs of care. Job Summary: The Clinical Care Manager-Massachusetts is a community based registered nurse responsible for providing monitoring, follow-up and clinical care management to dually-eligible enrollees with complex medical, behavioral and social care needs. This position focuses on integrating health services and community resources to coordinate enrollee care for improve health outcomes and enhanced quality of life. Essential Functions: • Engage with the enrollee in their homes and other community settings to establish an effective, complex care management relationship, while considering the cultural and linguistic needs of each member., • Function as a liaison between healthcare providers, community resources, and enrollees to ensure seamless communication and care transitions., • Perform required assessments on a timely basis, including but not limited to Comprehensive Assessment, MDS-HC (or successor) Functional Assessments, and Crisis and Risk Assessments, • Engage enrollees in care plan development and implementation, providing routine updates as the enrollee's status changes, • Lead the interdisciplinary care team (ICT) and collaborate with peers both internal and external to the organization, to create holistic care plans that address medical and non-medical needs., • Oversee enrollee utilization of long-term services and supports, ensuring appropriate systems are in place for enrollees to remain in the location of their choice, • Assist members in accessing community resources, including housing, transportation, food assistance, and social services., • Educate members about their benefits and available services under both Medicare and Medicaid., • Provide education to members and their families about managing chronic conditions, medication adherence, and preventive care., • Promote healthy lifestyle choices and self-management strategies., • Assist enrollees in preventative health strategies, including gap closure, • Follow up with members after hospitalizations or significant health events to ensure continuity of care and prevent readmissions., • Work closely with primary care physicians, specialists, and other healthcare providers to coordinate care and share relevant information., • Coordinate with community-based organizations, other stakeholders/entities, state agencies, and other service providers to ensure coordination and avoid duplication of services., • Advocate for the needs and preferences of enrollees within the healthcare system., • Evaluate member satisfaction through open communication and monitoring of concerns or issues., • Regular travel to conduct member, provider and community-based visits as required, • Report abuse, neglect, or exploitation of older adults and adults with disabilities as a mandated reporter as required by State law., • Adherence to NCQA and Care Management standards, • Performs any other job related duties as requested. Education and Experience: • Associates of Science (A.S) degree in nursing from an accredited nursing program required or, • Master's degree in social work or mental health counseling and independent license required, • Three (3) years of experience as a Registered Nurse/BH Clinician or, • One (1) year as a Registered Nurse/BH Clinician with two (2) years of experience working with people with complex medical, behavioral and social needs as an LPN, CHW, MA required, • Prior experience in care coordination, case management, or working with dual-eligible populations preferred, • Medicaid and/or Medicare managed care experience preferred Competencies, Knowledge and Skills: • Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel., • Understanding of Medicare and Medicaid programs, as well community resources and services available to dual-eligible beneficiaries., • Strong interpersonal and communication skills to effectively engage with members, families, and healthcare providers, • Ability to manage multiple cases and priorities while maintaining attention to detail., • Adhere to code of ethics that aligns with professional practice., • Awareness of and sensitivity to the diverse backgrounds and needs of the populations served, • Decision making and problem-solving skills., • Ability to function independently and effectively as part of an interdisciplinary team, • Strong and effective communication skills, both written and verbal, • Strong interpersonal and customer relations skills, • Strong customer service skills Licensure and Certification: • Current unrestricted clinical license in the Commonwealth of Massachusetts as a Registered Nurse (RN), Licensed Clinical Social Worker (LCSW), Licensed Independent Clinical Social Worker (LISCW), or a Licensed Mental Health Counselor (LMHC) required, • Case Management Certification is highly preferred, • Must have valid driver's license, vehicle and verifiable insurance. Employment in this position is conditional pending successful clearance of a driver's license record check. If the driver's license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in this position will be terminated, • To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 - March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified., • CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process. Working Conditions: • This is a mobile position, meaning that regular travel to different work locations, including homes, offices or other public settings, is essential. Will be exposed to weather conditions typical of the location and may be required to stand and/or sit for long periods of time. Must reside in the same territory they are assigned to work in; exceptions may be considered, due to business need May be required to travel greater than 50% of time to perform work duties. Required to use general office equipment, such as a telephone, photocopier, fax machine, and computer Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our members • Must live within commutable distance to the Commonwealth of Massachusetts, • Over 50% (Mobile) Routine travel required Compensation Range: $90,000 - $120,000 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type: Salary Competencies: • Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

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: 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. 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. Mass General Brigham Community Physicians, Inc. 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.

Commonwealth Care Alliance (CCA) is a nonprofit, mission-driven health plan and care delivery organization designed for individuals with the most significant needs. As an affiliate of CareSource, a nationally recognized nonprofit managed care organization with over 2 million members across multiple states, CCA serves individuals enrolled in Medicaid and Medicare in Massachusetts through the Senior Care Options and One Care programs and its care delivery enterprises. CCA is dedicated to delivering comprehensive, integrated, and person-centered care, powered by its unique model of uncommon care, which yields improved quality outcomes and lower costs of care. Job Summary: The Clinical Care Manager-Massachusetts is a community based registered nurse responsible for providing monitoring, follow-up and clinical care management to dually-eligible enrollees with complex medical, behavioral and social care needs. This position focuses on integrating health services and community resources to coordinate enrollee care for improve health outcomes and enhanced quality of life. Essential Functions: • Engage with the enrollee in their homes and other community settings to establish an effective, complex care management relationship, while considering the cultural and linguistic needs of each member., • Function as a liaison between healthcare providers, community resources, and enrollees to ensure seamless communication and care transitions., • Perform required assessments on a timely basis, including but not limited to Comprehensive Assessment, MDS-HC (or successor) Functional Assessments, and Crisis and Risk Assessments, • Engage enrollees in care plan development and implementation, providing routine updates as the enrollee's status changes, • Lead the interdisciplinary care team (ICT) and collaborate with peers both internal and external to the organization, to create holistic care plans that address medical and non-medical needs., • Oversee enrollee utilization of long-term services and supports, ensuring appropriate systems are in place for enrollees to remain in the location of their choice, • Assist members in accessing community resources, including housing, transportation, food assistance, and social services., • Educate members about their benefits and available services under both Medicare and Medicaid., • Provide education to members and their families about managing chronic conditions, medication adherence, and preventive care., • Promote healthy lifestyle choices and self-management strategies., • Assist enrollees in preventative health strategies, including gap closure, • Follow up with members after hospitalizations or significant health events to ensure continuity of care and prevent readmissions., • Work closely with primary care physicians, specialists, and other healthcare providers to coordinate care and share relevant information., • Coordinate with community-based organizations, other stakeholders/entities, state agencies, and other service providers to ensure coordination and avoid duplication of services., • Advocate for the needs and preferences of enrollees within the healthcare system., • Evaluate member satisfaction through open communication and monitoring of concerns or issues., • Regular travel to conduct member, provider and community-based visits as required, • Report abuse, neglect, or exploitation of older adults and adults with disabilities as a mandated reporter as required by State law., • Adherence to NCQA and Care Management standards, • Performs any other job related duties as requested. Education and Experience: • Associates of Science (A.S) degree in nursing from an accredited nursing program required or, • Master's degree in social work or mental health counseling and independent license required, • Three (3) years of experience as a Registered Nurse/BH Clinician or, • One (1) year as a Registered Nurse/BH Clinician with two (2) years of experience working with people with complex medical, behavioral and social needs as an LPN, CHW, MA required, • Prior experience in care coordination, case management, or working with dual-eligible populations preferred, • Medicaid and/or Medicare managed care experience preferred Competencies, Knowledge and Skills: • Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel., • Understanding of Medicare and Medicaid programs, as well community resources and services available to dual-eligible beneficiaries., • Strong interpersonal and communication skills to effectively engage with members, families, and healthcare providers, • Ability to manage multiple cases and priorities while maintaining attention to detail., • Adhere to code of ethics that aligns with professional practice., • Awareness of and sensitivity to the diverse backgrounds and needs of the populations served, • Decision making and problem-solving skills., • Ability to function independently and effectively as part of an interdisciplinary team, • Strong and effective communication skills, both written and verbal, • Strong interpersonal and customer relations skills, • Strong customer service skills Licensure and Certification: • Current unrestricted clinical license in the Commonwealth of Massachusetts as a Registered Nurse (RN), Licensed Clinical Social Worker (LCSW), Licensed Independent Clinical Social Worker (LISCW), or a Licensed Mental Health Counselor (LMHC) required, • Case Management Certification is highly preferred, • Must have valid driver's license, vehicle and verifiable insurance. Employment in this position is conditional pending successful clearance of a driver's license record check. If the driver's license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in this position will be terminated, • To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 - March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified., • CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process. Working Conditions: • This is a mobile position, meaning that regular travel to different work locations, including homes, offices or other public settings, is essential. Will be exposed to weather conditions typical of the location and may be required to stand and/or sit for long periods of time. Must reside in the same territory they are assigned to work in; exceptions may be considered, due to business need May be required to travel greater than 50% of time to perform work duties. Required to use general office equipment, such as a telephone, photocopier, fax machine, and computer Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our members • Must live within commutable distance to the Commonwealth of Massachusetts, • Over 50% (Mobile) Routine travel required Compensation Range: $90,000 - $120,000 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type: Salary Competencies: • Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

Commonwealth Care Alliance (CCA) is a nonprofit, mission-driven health plan and care delivery organization designed for individuals with the most significant needs. As an affiliate of CareSource, a nationally recognized nonprofit managed care organization with over 2 million members across multiple states, CCA serves individuals enrolled in Medicaid and Medicare in Massachusetts through the Senior Care Options and One Care programs and its care delivery enterprises. CCA is dedicated to delivering comprehensive, integrated, and person-centered care, powered by its unique model of uncommon care, which yields improved quality outcomes and lower costs of care. Job Summary: The Clinical Care Manager-Massachusetts is a community based registered nurse responsible for providing monitoring, follow-up and clinical care management to dually-eligible enrollees with complex medical, behavioral and social care needs. This position focuses on integrating health services and community resources to coordinate enrollee care for improve health outcomes and enhanced quality of life. Essential Functions: • Engage with the enrollee in their homes and other community settings to establish an effective, complex care management relationship, while considering the cultural and linguistic needs of each member., • Function as a liaison between healthcare providers, community resources, and enrollees to ensure seamless communication and care transitions., • Perform required assessments on a timely basis, including but not limited to Comprehensive Assessment, MDS-HC (or successor) Functional Assessments, and Crisis and Risk Assessments, • Engage enrollees in care plan development and implementation, providing routine updates as the enrollee's status changes, • Lead the interdisciplinary care team (ICT) and collaborate with peers both internal and external to the organization, to create holistic care plans that address medical and non-medical needs., • Oversee enrollee utilization of long-term services and supports, ensuring appropriate systems are in place for enrollees to remain in the location of their choice, • Assist members in accessing community resources, including housing, transportation, food assistance, and social services., • Educate members about their benefits and available services under both Medicare and Medicaid., • Provide education to members and their families about managing chronic conditions, medication adherence, and preventive care., • Promote healthy lifestyle choices and self-management strategies., • Assist enrollees in preventative health strategies, including gap closure, • Follow up with members after hospitalizations or significant health events to ensure continuity of care and prevent readmissions., • Work closely with primary care physicians, specialists, and other healthcare providers to coordinate care and share relevant information., • Coordinate with community-based organizations, other stakeholders/entities, state agencies, and other service providers to ensure coordination and avoid duplication of services., • Advocate for the needs and preferences of enrollees within the healthcare system., • Evaluate member satisfaction through open communication and monitoring of concerns or issues., • Regular travel to conduct member, provider and community-based visits as required, • Report abuse, neglect, or exploitation of older adults and adults with disabilities as a mandated reporter as required by State law., • Adherence to NCQA and Care Management standards, • Performs any other job related duties as requested. Education and Experience: • Associates of Science (A.S) degree in nursing from an accredited nursing program required or, • Master's degree in social work or mental health counseling and independent license required, • Three (3) years of experience as a Registered Nurse/BH Clinician or, • One (1) year as a Registered Nurse/BH Clinician with two (2) years of experience working with people with complex medical, behavioral and social needs as an LPN, CHW, MA required, • Prior experience in care coordination, case management, or working with dual-eligible populations preferred, • Medicaid and/or Medicare managed care experience preferred Competencies, Knowledge and Skills:, • Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel., • Understanding of Medicare and Medicaid programs, as well community resources and services available to dual-eligible beneficiaries., • Strong interpersonal and communication skills to effectively engage with members, families, and healthcare providers, • Ability to manage multiple cases and priorities while maintaining attention to detail., • Adhere to code of ethics that aligns with professional practice., • Awareness of and sensitivity to the diverse backgrounds and needs of the populations served, • Decision making and problem-solving skills., • Ability to function independently and effectively as part of an interdisciplinary team, • Strong and effective communication skills, both written and verbal, • Strong interpersonal and customer relations skills, • Strong customer service skillsLicensure and Certification:, • Current unrestricted clinical license in the Commonwealth of Massachusetts as a Registered Nurse (RN), Licensed Clinical Social Worker (LCSW), Licensed Independent Clinical Social Worker (LISCW), or a Licensed Mental Health Counselor (LMHC) required, • Case Management Certification is highly preferred, • Must have valid driver's license, vehicle and verifiable insurance. Employment in this position is conditional pending successful clearance of a driver's license record check. If the driver's license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in this position will be terminated, • To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 - March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified., • CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process.Working Conditions:, • This is a mobile position, meaning that regular travel to different work locations, including homes, offices or other public settings, is essential. Will be exposed to weather conditions typical of the location and may be required to stand and/or sit for long periods of time. Must reside in the same territory they are assigned to work in; exceptions may be considered, due to business need May be required to travel greater than 50% of time to perform work duties. Required to use general office equipment, such as a telephone, photocopier, fax machine, and computer Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our members, • Must live within commutable distance to the Commonwealth of Massachusetts, • Over 50% (Mobile) Routine travel required Compensation Range: $90,000 - $120,000 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type: Salary Competencies: • Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

Commonwealth Care Alliance (CCA) is a nonprofit, mission-driven health plan and care delivery organization designed for individuals with the most significant needs. As an affiliate of CareSource, a nationally recognized nonprofit managed care organization with over 2 million members across multiple states, CCA serves individuals enrolled in Medicaid and Medicare in Massachusetts through the Senior Care Options and One Care programs and its care delivery enterprises. CCA is dedicated to delivering comprehensive, integrated, and person-centered care, powered by its unique model of uncommon care, which yields improved quality outcomes and lower costs of care. Job Summary: The Clinical Care Manager-Massachusetts is a community based registered nurse responsible for providing monitoring, follow-up and clinical care management to dually-eligible enrollees with complex medical, behavioral and social care needs. This position focuses on integrating health services and community resources to coordinate enrollee care for improve health outcomes and enhanced quality of life. Essential Functions: • Engage with the enrollee in their homes and other community settings to establish an effective, complex care management relationship, while considering the cultural and linguistic needs of each member., • Function as a liaison between healthcare providers, community resources, and enrollees to ensure seamless communication and care transitions., • Perform required assessments on a timely basis, including but not limited to Comprehensive Assessment, MDS-HC (or successor) Functional Assessments, and Crisis and Risk Assessments, • Engage enrollees in care plan development and implementation, providing routine updates as the enrollee's status changes, • Lead the interdisciplinary care team (ICT) and collaborate with peers both internal and external to the organization, to create holistic care plans that address medical and non-medical needs., • Oversee enrollee utilization of long-term services and supports, ensuring appropriate systems are in place for enrollees to remain in the location of their choice, • Assist members in accessing community resources, including housing, transportation, food assistance, and social services., • Educate members about their benefits and available services under both Medicare and Medicaid., • Provide education to members and their families about managing chronic conditions, medication adherence, and preventive care., • Promote healthy lifestyle choices and self-management strategies., • Assist enrollees in preventative health strategies, including gap closure, • Follow up with members after hospitalizations or significant health events to ensure continuity of care and prevent readmissions., • Work closely with primary care physicians, specialists, and other healthcare providers to coordinate care and share relevant information., • Coordinate with community-based organizations, other stakeholders/entities, state agencies, and other service providers to ensure coordination and avoid duplication of services., • Advocate for the needs and preferences of enrollees within the healthcare system., • Evaluate member satisfaction through open communication and monitoring of concerns or issues., • Regular travel to conduct member, provider and community-based visits as required, • Report abuse, neglect, or exploitation of older adults and adults with disabilities as a mandated reporter as required by State law., • Adherence to NCQA and Care Management standards, • Performs any other job related duties as requested. Education and Experience: • Associates of Science (A.S) degree in nursing from an accredited nursing program required or, • Master's degree in social work or mental health counseling and independent license required, • Three (3) years of experience as a Registered Nurse/BH Clinician or, • One (1) year as a Registered Nurse/BH Clinician with two (2) years of experience working with people with complex medical, behavioral and social needs as an LPN, CHW, MA required, • Prior experience in care coordination, case management, or working with dual-eligible populations preferred, • Medicaid and/or Medicare managed care experience preferred Competencies, Knowledge and Skills:, • Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel., • Understanding of Medicare and Medicaid programs, as well community resources and services available to dual-eligible beneficiaries., • Strong interpersonal and communication skills to effectively engage with members, families, and healthcare providers, • Ability to manage multiple cases and priorities while maintaining attention to detail., • Adhere to code of ethics that aligns with professional practice., • Awareness of and sensitivity to the diverse backgrounds and needs of the populations served, • Decision making and problem-solving skills., • Ability to function independently and effectively as part of an interdisciplinary team, • Strong and effective communication skills, both written and verbal, • Strong interpersonal and customer relations skills, • Strong customer service skillsLicensure and Certification:, • Current unrestricted clinical license in the Commonwealth of Massachusetts as a Registered Nurse (RN), Licensed Clinical Social Worker (LCSW), Licensed Independent Clinical Social Worker (LISCW), or a Licensed Mental Health Counselor (LMHC) required, • Case Management Certification is highly preferred, • Must have valid driver's license, vehicle and verifiable insurance. Employment in this position is conditional pending successful clearance of a driver's license record check. If the driver's license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in this position will be terminated, • To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 - March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified., • CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process.Working Conditions:, • This is a mobile position, meaning that regular travel to different work locations, including homes, offices or other public settings, is essential. Will be exposed to weather conditions typical of the location and may be required to stand and/or sit for long periods of time. Must reside in the same territory they are assigned to work in; exceptions may be considered, due to business need May be required to travel greater than 50% of time to perform work duties. Required to use general office equipment, such as a telephone, photocopier, fax machine, and computer Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our members, • Must live within commutable distance to the Commonwealth of Massachusetts, • Over 50% (Mobile) Routine travel required Compensation Range: $90,000 - $120,000 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type: Salary Competencies: • Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

Commonwealth Care Alliance (CCA) is a nonprofit, mission-driven health plan and care delivery organization designed for individuals with the most significant needs. As an affiliate of CareSource, a nationally recognized nonprofit managed care organization with over 2 million members across multiple states, CCA serves individuals enrolled in Medicaid and Medicare in Massachusetts through the Senior Care Options and One Care programs and its care delivery enterprises. CCA is dedicated to delivering comprehensive, integrated, and person-centered care, powered by its unique model of uncommon care, which yields improved quality outcomes and lower costs of care. Job Summary: The Clinical Care Manager-Massachusetts is a community based registered nurse responsible for providing monitoring, follow-up and clinical care management to dually-eligible enrollees with complex medical, behavioral and social care needs. This position focuses on integrating health services and community resources to coordinate enrollee care for improve health outcomes and enhanced quality of life. Essential Functions: • Engage with the enrollee in their homes and other community settings to establish an effective, complex care management relationship, while considering the cultural and linguistic needs of each member., • Function as a liaison between healthcare providers, community resources, and enrollees to ensure seamless communication and care transitions., • Perform required assessments on a timely basis, including but not limited to Comprehensive Assessment, MDS-HC (or successor) Functional Assessments, and Crisis and Risk Assessments, • Engage enrollees in care plan development and implementation, providing routine updates as the enrollee's status changes, • Lead the interdisciplinary care team (ICT) and collaborate with peers both internal and external to the organization, to create holistic care plans that address medical and non-medical needs., • Oversee enrollee utilization of long-term services and supports, ensuring appropriate systems are in place for enrollees to remain in the location of their choice, • Assist members in accessing community resources, including housing, transportation, food assistance, and social services., • Educate members about their benefits and available services under both Medicare and Medicaid., • Provide education to members and their families about managing chronic conditions, medication adherence, and preventive care., • Promote healthy lifestyle choices and self-management strategies., • Assist enrollees in preventative health strategies, including gap closure, • Follow up with members after hospitalizations or significant health events to ensure continuity of care and prevent readmissions., • Work closely with primary care physicians, specialists, and other healthcare providers to coordinate care and share relevant information., • Coordinate with community-based organizations, other stakeholders/entities, state agencies, and other service providers to ensure coordination and avoid duplication of services., • Advocate for the needs and preferences of enrollees within the healthcare system., • Evaluate member satisfaction through open communication and monitoring of concerns or issues., • Regular travel to conduct member, provider and community-based visits as required, • Report abuse, neglect, or exploitation of older adults and adults with disabilities as a mandated reporter as required by State law., • Adherence to NCQA and Care Management standards, • Performs any other job related duties as requested. Education and Experience: • Associates of Science (A.S) degree in nursing from an accredited nursing program required or, • Master's degree in social work or mental health counseling and independent license required, • Three (3) years of experience as a Registered Nurse/BH Clinician or, • One (1) year as a Registered Nurse/BH Clinician with two (2) years of experience working with people with complex medical, behavioral and social needs as an LPN, CHW, MA required, • Prior experience in care coordination, case management, or working with dual-eligible populations preferred, • Medicaid and/or Medicare managed care experience preferred Competencies, Knowledge and Skills:, • Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel., • Understanding of Medicare and Medicaid programs, as well community resources and services available to dual-eligible beneficiaries., • Strong interpersonal and communication skills to effectively engage with members, families, and healthcare providers, • Ability to manage multiple cases and priorities while maintaining attention to detail., • Adhere to code of ethics that aligns with professional practice., • Awareness of and sensitivity to the diverse backgrounds and needs of the populations served, • Decision making and problem-solving skills., • Ability to function independently and effectively as part of an interdisciplinary team, • Strong and effective communication skills, both written and verbal, • Strong interpersonal and customer relations skills, • Strong customer service skillsLicensure and Certification:, • Current unrestricted clinical license in the Commonwealth of Massachusetts as a Registered Nurse (RN), Licensed Clinical Social Worker (LCSW), Licensed Independent Clinical Social Worker (LISCW), or a Licensed Mental Health Counselor (LMHC) required, • Case Management Certification is highly preferred, • Must have valid driver's license, vehicle and verifiable insurance. Employment in this position is conditional pending successful clearance of a driver's license record check. If the driver's license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in this position will be terminated, • To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 - March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified., • CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process.Working Conditions:, • This is a mobile position, meaning that regular travel to different work locations, including homes, offices or other public settings, is essential. Will be exposed to weather conditions typical of the location and may be required to stand and/or sit for long periods of time. Must reside in the same territory they are assigned to work in; exceptions may be considered, due to business need May be required to travel greater than 50% of time to perform work duties. Required to use general office equipment, such as a telephone, photocopier, fax machine, and computer Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our members, • Must live within commutable distance to the Commonwealth of Massachusetts, • Over 50% (Mobile) Routine travel required Compensation Range: $90,000 - $120,000 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type: Salary Competencies: • Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

The Peer-to-Peer (P2P) Utilization Review Nurse is an integral member of the MGB Central Utilization Management team, specializing in identifying, preparing, and clinically reviewing cases requiring peer-to-peer engagement with payers. This role focuses on concurrent level-of-care denials and supports physician advisor-led peer-to-peer discussions through expert clinical analysis, application of nationally recognized criteria, and comprehensive documentation. The P2P Utilization Review Nurse functions with a high degree of autonomy and clinical judgment, managing a high volume of complex cases across multiple entities. Working in close collaboration with Physician Advisors, Emergency Department providers, admitting teams, Care Management, and non-clinical UM partners, this role ensures accurate level-of-care determinations, supports appeal and reconsideration pathways, and promotes consistent, compliant utilization practices. The P2P Utilization Review Nurse reports to Utilization Management leadership within the centralized UM structure. Primary Responsibilities: -Apply nationally recognized criteria (InterQual and/or MCG) and organizational guidelines to evaluate payer denials and determine appropriateness of inpatient versus observation status. -Perform detailed clinical record reviews to assess medical necessity, intensity of service, and severity of illness in preparation for peer-to-peer review and identify cases appropriate for peer-to-peer review versus downgrade or reconsideration (CONI), using established exclusionary criteria and the P2P Standard of Work. -Document clinical rationale, level-of-care determinations, and recommendations clearly and accurately in EPIC, utilization management notes, and designated tracking tools, and maintain and update required P2P tracking tools, including documenting review status, outcomes, and next steps in accordance with standardized workflows. -Collaborate closely with Physician Advisors to prepare cases for peer-to-peer discussions, including participation in scheduled prep meetings and real-time clinical clarification. -Serve as a subject matter expert for utilization management, payer denial trends, and peer-to-peer workflows for internal stakeholders and communicate effectively with Emergency Department providers, admitting providers, Care Managers, and UM colleagues to ensure alignment on patient class determinations and care progression. -Support reconsideration (CONI) processes through RN-to-RN collaboration with payers when new or additional clinical information becomes available, and escalate complex or unresolved cases to Physician Advisors when payer determinations conflict with clinical findings or established criteria. -Assist with departmental needs during periods of high demand, including additional reviews, appeal preparation, and workflow support, and participate in quality improvement initiatives, denial trend analysis, and identification of learning opportunities related to utilization management and peer-to-peer outcomes. -Complete special assignments and projects demonstrating expert-level knowledge of utilization review criteria and peer-to-peer processes. Qualifications Required: Bachelor's of Science, Nursing (BSN) RN license 5+ years clinical nursing experience in an acute care hospital setting 3+ years utilization review, care management or utilization management experience 1+ years experience applying InterQual and/or MCG criteria for level of care determination 1+ years experience reviewing and managing payer denials, ability to perform independent, complex clinical record reviews, and experience collaborating with physicians, physician advisors, and interdisciplinary teams to resolve level of care issues Proficiency with electronic medical records (EPIC preferred) and utilization management documentation workflows Preferred: Experience supporting or preparing cases for peer-to-peer (P2P) discussions with payers Certification in Utilization Review (CPUR), Case Management (CCM), or related specialty Experience with appeals, reconsideration (CONI) processes, or denial trend analysis Additional Knowledge, Skills and Abilities: • Strong clinical background with the ability to synthesize complex medical information., • Expert-level knowledge of utilization review principles, level-of-care determination, and payer reimbursement guidelines., • Demonstrated proficiency with InterQual and/or MCG criteria., • Advanced critical thinking skills with confident, independent clinical decision-making., • Ability to influence, negotiate, and collaborate effectively with providers, physician advisors, and interdisciplinary teams., • Strong written and verbal communication skills, with emphasis on clear clinical documentation., • High level of organizational skills and ability to manage multiple complex cases simultaneously., • Comfort functions autonomously in a fast-paced, high-volume, centralized review environment., • Proficiency with EPIC and utilization management tracking tools. Schedule and Work Model Remote / Work from Home. 32 hours per week on a rotating schedule, within standard business hours. 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. 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.

Job Description Laughter. Fun. Being a role model and making a difference. Camp Kaleidoscope, the JCC summer day camp in Newton, draws creative campers interested in the arts, science and the outdoors. Camp Counselors and activity specialists guide campers in drama, art, science, sports, swimming and much more as they develop and build self-confidence. The energy of the camp is lively, playful and warm, as both campers and staff develop lifelong friendships. Our Camp Nurse / Healthcare Supervisor provides hands-on care and manages the distribution of medications and camper care throughout the day. JCC Greater Boston offers free bus service for staff from Cambridge, Brookline, Jamaica Plain, West Roxbury, Wayland, Framingham, Natick, Needham, Newton and Wellesley during the summer season. Why work with us? At our camps, the best part of the day is simple: the campers. Our staff say their favorite moments are playing games, cheering campers on at swim, creating art together, and bonding over shared interests. Staff describe camp as fun, dynamic, and inclusive. Here, you’ll gain leadership skills, make lasting friendships, and create unforgettable experiences – for campers and yourself. JCC Greater Boston is deeply committed to valuing and celebrating the uniqueness of each constituent. We welcome staff and participants from diverse backgrounds. While being proudly Jewish, we strive in every way to provide an open and welcoming setting for all, irrespective of personal practices, beliefs, or background. We are guided by JCC Greater Boston’s core values - Belonging, Joyfulness, Collaboration, and Transformation - which resonate with many who do not identify as Jewish. Primary responsibilities include, and are not limited to: • Work in partnership with camp staff to administer medications and provide camper care, • Ensure camper and staff medical documentation is current and on file, • Communicate with families and camp staff regarding needs and care received at camp, • Manage medical supply inventory and utilization, • Provide first aid and administer medications, • Maintain documentation and medical log, • Create and implement trainings and support tools for camper care and camp staff, • Ensure the safety and well-being of campers in structured and unstructured time, • Create a fun/joyful dynamic, • Work in partnership with peers and Camp Leadership to provide a happy, safe and memorable summer for the children, • Provide hands-on medical care to campers as needed Standard staff expectations include and are not limited to: • Actively create a welcoming dynamic that contributes to an environment where each individual is valued and respected, • Actively participate as an essential team member, • Support JCC Greater Boston’s mission, vision, and values of belonging, joyfulness, collaboration, and transformation, including through role modeling, • Enthusiastically representing the organization, model excellence and achievement, • Attend JCCGB meetings and trainings as assigned, • Other duties as assigned This is a great chance to join JCC Greater Boston's respected and valued, people-orientated workplace of diverse community services providers, which is rapidly growing! JOB DETAILS: This is an hourly position with a daily schedule of 8:30am - 4:30pm, Monday - Friday. Offering great perks, including JCC Health & Fitness center access, a supportive, vibrant in-person work environment, and a competitive starting pay rate of $22 per hour. The pay rate offered will ultimately be determined by relevant qualifications, experience, and JCC's internal equity. This 8 week camp program is June 22 - August 21, including staff training. While we prefer candidates who are available all summer, we recognize that candidates may have other obligations and are happy to work with your schedule. About JCC Greater Boston Since opening its doors in 1983, JCC Greater Boston has been committed to creating a vibrant, inclusive, diverse community by nurturing meaningful, lasting relationships. Through our network of early learning centers, day camps, regional teen and family programs, health and wellness offerings, and adult arts and ideas classes, JCC Greater Boston provides highly valued connections, learning, and experiences for the Jewish community and friends. JCC Greater Boston staff enjoy working in an innovative, friendly, and welcoming environment where their talents and contributions are appreciated. In our recent employee survey, staff rated their direct management and organizational alignment experiences close to 90% positive. If you want to upgrade your working experience and have a better work-life balance, we encourage you to explore becoming part of the JCC team! The JCC is deeply committed to valuing and celebrating the uniqueness of each constituent. We welcome staff and participants from diverse backgrounds. While being proudly Jewish, we strive in every way to provide an open and welcoming setting for all, irrespective of personal practices, beliefs, or background. We are guided by JCC Greater Boston's core values: Belonging, Joyfulness, Collaboration, and Transformation, which we hope resonate with all. To learn more about what makes JCC Greater Boston a wonderful place to work, please visit our careers page at https://www.bostonjcc.org/careers/ JCC Greater Boston is an equal opportunity employer and does not discriminate against any individual or group on the basis of gender, sexual orientation, gender identity or expression, age, race, color, religion, national origin, ancestry, veteran status, marital status, pregnancy, genetic information, or disability. In a continuing effort to maintain and enrich a diverse environment, we actively encourage applications from women and members of underrepresented groups. Requirements Education and Experience: • High school degree required, • College degree, concentration or equivalent certification and experience in nursing, healthcare, EMT, or similar field of study and/or comparable experience preferred, • 1+ year experience providing healthcare services, • Basic first aid and CPR certification required, • Customer service experience preferred Equivalent combination of education and experience may be substituted at the JCC’s discretion to meet minimum criteria. Skills and Abilities: • Ability to maintain documentation and medical log per applicable requirements, • Understands infectious disease best practices and ability to train others in proper protocol, • Ability and commitment to build strong relationships with campers, parents, co-workers, and camp leadership, • Safety awareness and ability to communicate any issues and concerns with supervisors, • Exhibits leadership skills, including teamwork, patience, flexibility, and diplomacy, • Demonstrates positive attitude at all times, • Commitment to build strong relationships with campers, co-workers, and camp leadership, • Self-starter who takes the initiative, • Ability to manage situations effectively and diplomatically and ask for help, guidance, or clarification when needed, • Must be able to work well with others, building/sustaining collaborative solid relationships Physical Requirements: • Able to work well in a busy, dynamic, and sometimes noisy environment involving multiple tasks and priorities., • Ability to work in variety of weather conditions for extended periods of time in case of rain, heat, humidity, cold, or other environmental factors to ensure the supervision and safety of campers in our care., • Able to lift and carry objects weighing 30-40 pounds (boxes of supplies, children’s backpacks, etc., • Able to sit and kneel; getting down at eye level with children regularly. ADA Statement: Individuals must possess these criteria for knowledge, skills, and abilities or be able to explain and demonstrate that the individual can perform the essential functions of the job, with or without reasonable accommodation and using some other combination of skills and abilities. Benefits In addition to offering rewarding work and great career opportunities within our mission-driven, values-driven, and family-centric environment, JCC Greater Boston proudly offers employees the generous benefits listed below. JCCGB Perks! Each seasonal employee is eligible for access to JCC Greater Boston's top class fitness, recreation and wellness facility in Newton! Seasonal access to the JCC Fitness Center includes: • Use of the Fitness Center at Leventhal-Sidman JCC during active seasonal employment, • Free or discounted enrollment for camp programs may be available for camp employees’ children based on availability. Benefits are subject to review and change by the Organization, and plan documents are the primary determinant. A Great Place to Work! JCC Greater Boston is consciously evolving as a great place to work! In our recent 2023 employee engagement survey, at least 88% of our staff gave us top ratings on: • Supportive colleagues, • Team camaraderie, • How their managers treat them, • Individual autonomy, • Knowing what their work contributes to and how it impacts others, • Pride in working for the JCC, • Program and service quality, • Holding ourselves accountable Our staff and leadership bring experience, excellence, and commitment to everything we offer and we are dedicated to a culture where all our employees may thrive. Our culture is built on our values, driven by our mission, and nurtured through the expert contributions of our professionals.

A healthcare provider is seeking a Utilization Management Clinical Manager for analyzing medical service requests. Responsibilities include reviewing authorization requests, managing incoming requests, and ensuring adherence to performance metrics.

Participating in Wound Rounds, Operations Meetings, Utilization Review, and Performance Improvement/Risk Management/Safety (PI/RM/S) Committee. Reviewing clinical outcomes to ensure that we stay above the National, State, and Erickson benchmarking thresholds. Minimum 3 years’ experience in a healt

LRS Healthcare - Nursing is seeking an experienced Case Manager Registered Nurse for an exciting Travel Nursing job in Boston, MA.

SambaTraveler is seeking an experienced Case Manager Registered Nurse for an exciting Travel Nursing job in Boston, MA.

LRS Healthcare - Nursing is seeking an experienced Case Manager Registered Nurse for an exciting Travel Nursing job in Boston, MA.

FlexCare is seeking an experienced Case Manager Registered Nurse for an exciting Travel Nursing job in Boston, MA.

Cynet Health is seeking an experienced Case Manager Registered Nurse for an exciting Travel Nursing job in Boston, MA.

Host Healthcare is seeking an experienced Case Manager Registered Nurse for an exciting Travel Nursing job in Boston, MA. As a nurse, allied, or therapy professional, you will be matched to one of our responsive recruiters who will have your back throughout your journey. You will also be connected w