Nursing Jobs in Downtown, MA
$95,000 - $100,000 / year
Overview The Nurse Case Manager will be covering and visiting members in North Chelmsford, Lawrence, Lynnfield, Medford, Medford, West Medford, Melrose, Stoneham, and Tewksbury. About us: Fallon Health is a company that cares. We prioritize our members—always—making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon Health delivers equitable, high-quality, coordinated care and is continually rated among the nation’s top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)— in the region. Learn more at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn. Brief summary of purpose: The Nurse Case Manager (NCM) is an integral part on an interdisciplinary team focused on care coordination, care management and improving access to and quality of care for Fallon members. NCM seeks to establish telephonic and/or face to face relationships with the member/caregiver(s) to better ensure ongoing service provision and care coordination, consistent with the member specific care plan developed by the NCM and Care Team. Responsibilities may include conducting in home face to face visits for member identified as needing face to face visit interaction and assessments with the goal to coordinate and facilitate services to meet member needs according to benefit tstructures and available community resources. The NCM may conduct assessments and may determine the number of hours’ members require for MassHealth programs such as the personal care attendant program, adult foster care, group adult foster care, and other programs per product benefits and guidelines. The NCM may utilize an ACD line to support department and incoming/outgoing calls with the goal of first call resolution with each interaction. Responsibilities Note: Job Responsibilities may vary depending upon the member’s Fallon Health Product Member Assessment, Education, and Advocacy Telephonically assesses and case manages a member panel May conduct in home face to face visits for onboarding new enrollees and reassessing members, utilizing a variety of interviewing techniques, including motivational interviewing, and employs culturally sensitive strategies to assess a Member’s clinical/functional status to identify ongoing special conditions and develops and implements an individualized,coordinated care plan, in collaboration with the member, the Clinical Integration team, and Primary Care Providers, Specialist and other community partners, to ensure a cost effective quality outcome Performs medication reconciliations Performs Care Transitions Assessments – per Program and product line processes Utilizing clinical judgment and nursing assessment skills, may complete NaviCare Program Assessment Tools and Minimum Data Set Home Care (MDS HC) Form when a member’s medical/functional status changes that warrants a change in rating category to ensure members are in the correct State defined rating category Maintains up to date knowledge of Program and product line benefits, Plan Evidence of Coverage details, and department policies and processes and follows policies and processes as outlined to be able to provide education to members and providers; performing a member advocacy and education role including but not limited to member rights Serves as an advocate for members to ensure they receive Fallon Health benefits as appropriate and if member needs are identified but not covered by Fallon Health, works with community agencies to facilitate access to programs such as community transportation, food programs, and other services available through senior centers and other external partners Follows department and regulatory standards to authorize and coordinate healthcare services ensuring timeliness in compliance with documented care plan goals and objectives Assesses the Member’s knowledge about the management of current disease processes and medication regimen, provides teaching to increase Member/caregiver knowledge, and works with the members to assist with learning how to self- manage his or her health needs, social needs or behavioral health needs Collaborates with appropriate team members to ensure health education/disease management information is provided as identified Collaborates with the interdisciplinary team in identifying and addressing high risk members Educate members on preventative screenings and other health care procedures such as vaccines, screenings according to established protocols and program processes such initiatives involving Key Metrics outreach Ensures members/PRAs participate in the development and approval of their care plans in conjunction with the interdisciplinary primary care team Strictly observes HIPAA regulations and the Fallon Health Policies regarding confidentiality of member information Supports Quality and Ad-Hoc campaigns Care Coordination and Collaboration Provides culturally appropriate care coordination, i.e. works with interpreters, provides communication approved documents in the appropriate language, and demonstrates culturally appropriate behavior when working with member, family, caregivers, and/or authorized representatives With member/authorized representative(s) collaboration develops member centered care plans by identifying member care needs while completing program assessments and working with the Navigator to ensure the member approves their care plan Manages NaviCare members in conjunction with the Navigator, Behavioral Health Case Manager, Aging Service Access Point Geriatric Support Service Coordinator, contracted Primary Care Providers and others involved/authorized in the member’s care Manages ACO members in conjunction with the Navigator, Social Care Managers, ACO Partners, Community Partners, Behavioral Health Partners and others involved/authorized in the member’s care Monitors progression of member goals and care plan goals, provides feedback and works collaboratively with care team members and work effectively in a team model approach to coordinate a continuum of care consistent with the Member’s health care goals and needs Works collaboratively with Fallon Health Pharmacist, referring members in need of medication review based upon Program process Develops and fosters relationships with members, family, caregivers, PRAs, vendors and providers to ensure good collaboration and coordination by streamlining the focus of the Member’s healthcare needs utilizing the most optimal treatment approach, promoting timely provision of care, enhancing quality of life, and promoting cost-effectiveness of care Actively participates in clinical rounds Provider Partnerships and Collaboration May attend in person care plan meetings with providers and office staff and may lead care plan review with providers and care team as applicable. Demonstrates positive customer service actions and takes responsibility to ensure member and provider requests and needs are met Regulatory Requirements – Actions and Oversight Completes Program Assessments, Notes, Screenings, and Care Plans in the Centralized Enrollee Record according to product regulatory requirements and Program policies and processes Knowledge of and compliance with HEDIS and Medicare 5 Star measure processes, performing member education, outreach, and actions in conjunction with the Navigator and other members of the Clinical Integration and Partner Teams Performs other responsibilities as assigned by the Manager/designee Supports department colleagues, covering and assuming changes in assignment as assigned by Manager/designee Qualifications Education: Graduate from an accredited school of nursing mandatory and a Bachelors (or advanced) degree in nursing or a health care related field preferred. License : Active, unrestricted license as a Registered Nurse in Massachusetts Certification : Certification in Case Management strongly desired Other : Satisfactory Criminal Offender Record Information (CORI) results and reliable transportation Experience: • 1+ years of clinical experience as a Registered Nurse managing chronically ill members or experience in a coordinated care program required• Understanding of Hospitalization experiences and the impacts and needs after facility discharge required• Experience working face to face with members and providers preferred• Experience with telephonic interviewing skills and working with a diverse population, that may also be Non-English speaking, required• Home Health Care experience preferred• Effective case management and care coordination skills and the ability to assess a member’s activities of daily function and independent activities of daily function and the ability to develop and implement a care plan that meets the member’s need working in partnership with a care team preferred• Familiarity with NCQA case management requirements preferred Performance Requirements including but not limited to: • Excellent communication and interpersonal skills with members and providers via telephone and in person• Exceptional customer service skills and willingness to assist ensuring timely resolution• Excellent organizational skills and ability to multi-task• Appreciation and adherence to policy and process requirements• Independent learning skills and success with various learning methodologies including but not limited to: self-study, mentoring, classroom, and group education• Working with an interdisciplinary care team as a partner demonstrating respect and value for all roles and is a positive contributor within job role scope and duties• Willingness to learn insurance regulatory and accreditation requirements• Knowledgeable about software systems including but not limited to Microsoft Office Products – Excel, Outlook, and Word • Familiar with Excel spreadsheets to manage work and exposure and familiarity with pivot tables• Accurate and timely data entry• Effective case management and care coordination skills and the ability to assess a member’s activities of daily function and independent activities of daily function and the ability to develop and implement a care plan that meets the member’s need • Knowledge about community resources, levels of care, criteria for levels of care and the ability to appropriately develop and implement a care plan following regulatory guidelines and level of care criteria • Ability to effectively respond and adapt to changing business needs and be an innovative and creative problem solver Competencies: • Demonstrates commitment to the Fallon Health Mission, Values, and Vision• Specific competencies essential to this position: Problem Solving Asks good questions Critical thinking skills; looks beyond the obvious Adaptability Handles day to day work challenges confidently Willing and able to adjust to multiple demands, shifing priorities, ambiguity, and rapid change Demonstrates flexibility Written Communication Is able to write clearly and succinctly in a variety of communication settings and styles. Pay Range Disclosure: In accordance with the Massachusetts Wage Transparency Act, the pay range for this position is $95,000 - $100,000 per year, which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate’s experience, skills, and fit with the role’s responsibilities. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. #P01 
$122,301.82 - $155,933.24 / year
Job Overview The Clinical Manager – Home Health & Hospice directs, coordinates and evaluates the delivery of home health and hospice weekend services and operations. Ensures compliance and consistency with agency policy, State and federal home health regulations. Responsible for the management of cost effective, efficient care to home health and hospice patients ensuring the delivery of outcome based to meet the individual needs of patients. Acts as a role model and mentor professionally and clinically for the implementation of the organization’s Mission and Core Value statements. Location: Lowell, MA Hours: Weekends (Friday-Monday) 32 Hours Friday (4 Hours) Saturday and Sunday (12 Hour Shifts) Monday (4 Hours) Job Description Minimum Qualifications: 1.Current licensure as a Registered Nurse or Physical Therapist. 2. Massachusetts RN Licensure OR Physical Therapy (PT) Licensure. 3.Three (3) years of home health or hospice experience. 4.Current Basic Life Support (BLS) Certification Preferred Qualifications: 1. Bachelor’s prepared level preferred-Registered Nurse BSN preferred, or Physical Therapist with two (2) years’ experience in community health/home health 2. Prior Supervisory experience. Duties and Responsibilities: The duties and responsibilities listed below are intended to describe the general nature of work and are not intended to be an all-inclusive list. Other duties and responsibilities may be assigned. Provides leadership, dependable clinical guidance, and support to weekend clinical and administrative staff. Provides the direct management of the Weekend clinical staff, schedulers, intake supervisor and Weekend Clinical coordinators. Provides supervision to clinical staff rotating to the weekend assignments. Assumes AOC coverage after hours Saturday and Sunday. Oversees the weekend scheduling, makes adjustments as necessary to maximize resources Provides direct clinical supervision, performance evaluations. Evaluates and ensures that competency requirements are met for all staff. Performs in home supervisory visits with assigned team members at least annually. Collaborates with HR in aspects of personnel management such as interviewing, hiring, and disciplinary action. Communicates regularly with supervisors and staff and communicates with all departments regarding pre and post weekend follow-up. Promotes efficient utilization of resources to achieve desired clinical outcomes and within episode reimbursement. Provide effective guidance to professional staff regarding: justification for appropriate home health and hospice service utilization in terms of frequency, duration, and type of service; rationale for clinical interventions based on patient condition, family, and community resources and the POC. Conducts individual caseload reviews, at the SOC and ongoing, and team meetings on a regularly scheduled basis according to the agency’s standards. Case conferences with staff as needed to meet the needs of challenging clients. Takes a proactive approach in identifying high utilization and problem prone cases; takes appropriate action. Accessible for staff consultation and problem solving. Handle clinical emergencies, complex problem solving. Ensures appropriate levels of clinical coverage based on census, multidisciplinary skill mix, geographic distribution, and patient care requirements. Participates in administrative On Call managerial coverage for weekends and holidays coverage as assigned. Arranges for managerial coverage when off. Researches and follows through with customer and employee complaints in a timely fashion. Follow through with employee complaints. Enhances professional growth through attendance at in-services, conferences, and professional organizations Evaluate staff understanding of documentation and compliance with regulations (Medicaid, Medicare, DPH, OSHA, JCAHO, State and Federal) with QA input. Reviews all payroll and ensures timely documentation within agency guidelines Demonstrates a knowledge and understanding of what to report to the supervisor or Director of Quality Improvement when concerns of corporate compliance arise. Ensures compliance within guidelines set forth by regulatory agencies (JCAHO, DPH, ERISA etc.) and demonstrates compliance with Tufts Medicine Care at Home policies and procedures. Practices confidentiality principles set by the agency and federal HIPAA guidelines. Participates in all mandatory in-services. What We Offer: Competitive salaries & benefits that start on day one! 403(b) retirement with company match Tuition reimbursement Fleet Car Program At Tufts Medicine, we want every individual to feel valued for the skills and experience they bring. Our compensation philosophy is designed to offer fair, competitive pay that attracts, retains, and motivates highly talented individuals, while rewarding the important work you do every day. The base pay ranges reflect the minimum qualifications for the role. Individual offers are determined using a comprehensive approach that considers relevant experience, certifications, education, skills, and internal equity to ensure compensation is fair, consistent, and aligned with our business goals. Beyond base pay, Tufts Medicine provides a comprehensive Total Rewards package that supports your health, financial security, and career growth—one of the many ways we invest in you so you can thrive both at work and outside of it. Pay Range : $122,301.82 - $155,933.24 $84,300.22 - $107,481.20 / year
Why Join Us? Newly adjusted Sign On Bonuses Recently increased market salaries Generous benefits that are effective day one Fleet car program: company paid vehicle, includes insurance, business miles and maintenance. Must meet eligibility requirements Company laptop and phone Job Overview Utilizing the nursing process, the Home Health Registered Nurse will manage and deliver comprehensive home health services, including assessments, interventions, and supportive care to clients within their place of residence. Depending on the circumstances, duties may also include telephone triage, problem solving, patient/caregiver advocacy and support, with emphasis of avoiding hospitalization. As a key member of the health care team, this position must interact courteously and effectively with patients and their families as well as with coworkers from all Agency departments, community resources, and with patients' physicians in order to facilitate safe and efficient patient care while maintaining their own safety in the home and the community at large. Location: Lowell, MA Hours: Full-Time, Days, 40 Hours Minimum Qualifications: 1. Massachusetts/New Hampshire RN Licensure. 2. Valid state issued Driver’s License. 3. One (1) year of acute medical/surgical nursing experience. 4. Cardiopulmonary Resuscitation (CPR) Certification. Duties and Responsibilities: The duties and responsibilities listed below are intended to describe the general nature of work and are not intended to be an all-inclusive list. Other duties and responsibilities may be assigned. Essential Functions: Assesses patients' physical, psychosocial needs in a sensitive, caring manner following established Standards of Nursing Practice and VNA procedures. Assesses patient/family learning needs, style and limitations and adjusts for delivery of information. Establishes realistic goals and develops plans of treatment in cooperation with the patient, family and members of the health care team. Adapts to new and unusual situations without affecting work performance negatively. Utilizes Security when and if needed for any potential unsafe situations. Collaborates with patient /family and other health care providers and/or community resources with planning of care and discharge. Completes physicians' orders, levels of care, and OASIS on all patients assigned, in accordance with patient care policies. Reconciles medications with patient and physician consistently. Demonstrates ability to cope with patient/family emotional stress and provide appropriate supportive care. Effectively manages assigned caseload, within the team model of care delivery. Establishes a daily work plan based upon patient/family priorities of service and total area needs. Promptly triages patient visits, messages, and phone calls according to priority and urgency. Demonstrates excellent physical assessment and care planning skills. Demonstrates current knowledge of pharmacology and medication administration and reconciliation. Demonstrates ability to cope with patient/family emotional stress and provide appropriate supportive care. Effectively manages assigned caseload, within the team model of care delivery. Establishes a daily work plan based upon patient/family priorities of service and total area needs. Promptly triages patient visits, messages, and phone calls according to priority and urgency. Coordinates care and discharge planning with other team members during case conferences. Acquires and maintains an expert working knowledge of all third part payers and regulatory bodies and agency policies on issues related to documentation and care provided. Communicates and collaborates with all disciplines in the home care setting on a regular basis or immediately if there are any critical needs or crisis interventions needed. What We Offer: Competitive salaries & benefits that start on day one! 403(b) retirement with company match Tuition reimbursement Fleet Car Program At Tufts Medicine, we want every individual to feel valued for the skills and experience they bring. Our compensation philosophy is designed to offer fair, competitive pay that attracts, retains, and motivates highly talented individuals, while rewarding the important work you do every day. The base pay ranges reflect the minimum qualifications for the role. Individual offers are determined using a comprehensive approach that considers relevant experience, certifications, education, skills, and internal equity to ensure compensation is fair, consistent, and aligned with our business goals. Beyond base pay, Tufts Medicine provides a comprehensive Total Rewards package that supports your health, financial security, and career growth—one of the many ways we invest in you so you can thrive both at work and outside of it. Pay Range : $84,300.22 - $107,481.20 $84,300.22 - $107,481.20 / year
Job Overview The position is a member of the hospice staff who determines appropriateness of referrals, coordinates and conducts pre-admission activities, completes admission when determined hospice appropriate, monitors inpatient care at contracted hospitals, performs in-service training and community education activities. This position performs duties in a variety of settings including 6patient’s home, acute care setting, skilled nursing facility or assisted living. Job Description Minimum Qualifications: 1. Massachusetts RN Licensure. 2. Hospice and/or end of life experience required. Location : Lowell MA Hours : Full Time- 40 Hours, Flexible shifts (8/10/12 Hour days) Holiday and Weekend Rotation Duties and Responsibilities: The duties and responsibilities listed below are intended to describe the general nature of work and are not intended to be an all-inclusive list. Other duties and responsibilities may be assigned. Describes and explains hospice services to a potential patient and/or family member and elicits responses to questions regarding attitude towards hospice care, evaluates physical and psycho/social/emotional status, in order to put the patient and family at ease about choosing hospice and fully inform them about the program. Works with hospice intake and eligibility department to verify insurance reimbursement for each referred patient and document in EMR. Reviews and explains to patient and/or family about insurance coverage and financial obligations, using knowledge of hospice fees, costs and reimbursement sources. Escalates to referral management director and/or referral manager, in circumstances of potential admission where reimbursement sources appear not to cover hospice fees, to ascertain whether reduce fee or free care may be offered. Introduces and explains benefits of hospice care and familiarizes decision makers with characteristics and needs that indicate an appropriate hospice referral. Presents the advantage of the hospice Medicare/Medicaid benefits to referral sources. Thoroughly understands the Medicare/Medicaid hospice benefit, the Medicare home health benefit, the Medicare/Medicaid long term benefit and the Medicare HMO benefit. Documents a narrative note in the EMR summarizing pertinent physical and psychosocial information from the hospital record and/or from the physician and patient/family assessment. Reviews referred patient’s history, medical status, and prognosis to determine eligibility for hospice services relying on the knowledge of hospital procedure and hospice admission criteria. Completes the patient/family admission packet, including obtaining signed Notice of Election of Hospice Benefit (NOE), admission forms from the patient, family, referral source and the attending physician. Uploading completed admission documents electronically to medical records for them to complete their process. Communicates information from Comprehensive Assessment to TMCAH CMO, hospice physician or TMCAH covering NP. Documents results and performs warm hand off to team. Communicates NTUC to appropriate staff and managers. Documents reason and continuation of care measures implemented. Promotes hospice services, to ensure appropriate referrals to hospice program, may perform liaison activities centered in the acute care setting, which include but not limited to, case conferences to case managers, discharge planners, physicians, other health care providers and referral sources. Works with TMCAH liaison and intake staff to ensure ease of referral, as well as a rapid response to the referral source. Evaluates and compares information, regarding referred patient to hospice criteria. Consult with either the referral management director, referral manager, CMO, or hospice physician when an admission is questionable. Communicates on a regular basis with patient, family, referral source, hospice intake or liaison staff, to ensure continuity of care and adherence to the hospice plan of care. Develops opportunities for and conducts in-service presentations in health care facilities regarding hospice care and the indications for a hospice referral. Joins approved professional organizations and other groups which include key decision makers in the care of terminally ill patients. Assists with public relations activities to promote community awareness of Hospice services. Includes activities during National Hospice Month. Reports Compliance concerns to the CEO or Chief Compliance Officer when applicable. Ensures compliance within guidelines set forth by regulatory agencies (DPH, ERISA etc.) and demonstrates compliance with Tufts Medicine Care at Home policies and procedures. What We Offer: Generous Paid Time Off (Effective Day1) Health, Dental and vision insurance (Effective Day 1) Competitive Salaries At Tufts Medicine, we want every individual to feel valued for the skills and experience they bring. Our compensation philosophy is designed to offer fair, competitive pay that attracts, retains, and motivates highly talented individuals, while rewarding the important work you do every day. The base pay ranges reflect the minimum qualifications for the role. Individual offers are determined using a comprehensive approach that considers relevant experience, certifications, education, skills, and internal equity to ensure compensation is fair, consistent, and aligned with our business goals. Beyond base pay, Tufts Medicine provides a comprehensive Total Rewards package that supports your health, financial security, and career growth—one of the many ways we invest in you so you can thrive both at work and outside of it. Pay Range : $84,300.22 - $107,481.20 $84,300.22 - $107,481.20 / year
Tufts Medicine Care at Home is a proud member of Tufts Medicine, a health system that is rethinking how academic and community centers, local and national businesses, and technology and service innovators can all work together. So that clinicians can deliver expert care where it’s needed most and so that we can bring wellness back to health care, one person at a time. Why Join Us? Benefits you'll love, generous sign-on bonuses and more! Our Home Health RNs tell us they love the ability to work autonomously, to build strong rapport with their patients and families, and the flexibility in managing their schedules. Come join our growing health system. Job Overview This position a R egistered N urse (RN) who specializes in the assessment and treatment of skin, wound, pressure ulcers, and ostomies for inpatients and a lso assesses and treats outpatient ostomy patients when ordered by the prescribing MD. Within the RN scope of practice, the model of care delivery is collaborative and consultative with responsibilities associated but not limited to: (1) developing and providing individualized education and plan of care for patient/support persons (2) developing and providing direct care as required by patient condition (3) education of clinical staff on the plan of care (4) providing follow up monitoring and direct patient care as required . Develops and implements evidence - based policy and procedures and acts as a wound and ostomy resource support to clinical staff and other members of the health care team. Works closely with the nurse educators and other nursing leaders to proactively develop and implement continuing education programs, orientation classes for new employees. Serves on committees and specialized workgroups . Job Description Minimum Qualifications : 1. Associate’s Degree in Nursing and c ompletion of an accredited Nursing Program. 2. Registered Nurse (RN) license. 3. Wound, Ostomy, and Cont inence Nursing (WOCN) certification. 4. One (1) year of related e xperience. Hours: Monday- Friday 8-4:30 We’re looking for compassionate, reliable caregivers across multiple service territories, including Greater Lowell, Merrimack Valley, Essex County, North Shore, and surrounding communities, as well as territories in New Hampshire, including Merrimack Country, Hillsborough County and Rockingham County Duties and Responsibilities : The duties and responsibilities listed below are intended to describe the general nature of work and are not intended to be an all-inclusive list . Other duties and responsibilities may be assigned. Consults as ordered by MD on patients with complex wounds, skin, and ostomy issues and recommends appropriate plan of care . Provides direct care to patients with complex wound/skin care needs, including but not limited to: marking ostomy sites pre-op, changing ostomy appliances, and applying dressings and other interventions to wounds, recommending best practices for pressure relief. Provides culturally competent, individualized patient education in the specialty area of practice to prepare patient/ s.o . for self-care and care area transition, such as to Home Care agencies and other facilities. Develops clinical staff expertise in the delivery of evidence based best practice skin, wound, and ostomy care via informal unit based as well as continuing education in conjunction with nurse educators, and other members of the health care team. Works with leadership and under the orders of surgeons. Helps to develop an outpatient Ostomy Clinic Visit program to follow ostomy patients and provide education and care as needed. Continuously evaluates products and treatment strategies to provide current, cost effective care to patients with wound, skin and ostomy issues . Strives to establish standardization in both products and protocols for patient care management. Promotes optimal relationships with local vendors/representatives of wound and ostomy supplies. Helps develop and participates in quality management and performance improvement monitors , collects data (including skin, wound, ostomy reportable event issues) and implements initiatives for improvement. Participates in Pressure ulcer prevalence studies with goal of improving outcomes. Collaborates with health care providers across the continuum, to provide Complete Connected Care and advocate for patients and families in our communities served. Actively participates in Wound Care Committee, Nursing Practice Council, and other committees as assigned. What We Offer: Competitive salaries & benefits that start on day one! 403(b) retirement with company match Tuition reimbursement Fleet Car Program About Care at Home: Tufts Medicine Care at Home is a proud member of Tufts Medicine, a health system that is rethinking how academic and community centers, local and national businesses, and technology and service innovators can all work together. So that clinicians can deliver expert care where it’s needed most and so that we can bring wellness back to health care, one person at a time. About Tufts Medicine A healthcare system that works Tufts Medicine is more than a health system — we’re a community that empowers people to live their best lives by reimagining healthcare, advancing knowledge and pioneering discovery. Every team member plays an integral role in realizing our vision of creating the most equitable and frictionless healthcare experience in the world. Here, you’ll join an enthusiastic community that champions your growth and receive generous benefits to support you and your family’s well-being. Tufts Medicine is an equal opportunity employer At Tufts Medicine, we want every individual to feel valued for the skills and experience they bring. Our compensation philosophy is designed to offer fair, competitive pay that attracts, retains, and motivates highly talented individuals, while rewarding the important work you do every day. The base pay ranges reflect the minimum qualifications for the role. Individual offers are determined using a comprehensive approach that considers relevant experience, certifications, education, skills, and internal equity to ensure compensation is fair, consistent, and aligned with our business goals. Beyond base pay, Tufts Medicine provides a comprehensive Total Rewards package that supports your health, financial security, and career growth—one of the many ways we invest in you so you can thrive both at work and outside of it. Pay Range : $84,300.22 - $107,481.20 
$120,000 - $150,000 / year
When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives. The Manager of Care Management has overall responsibility and accountability for the ongoing management and implementation of BILHPN’s care management programs for eligible risk patients; Ambulatory, Care Transitions, Quality, Chronic Care or other innovative programs. The manager is a key collaborator in the development of population health management strategies, program development and implementation within the team he/she/they manage. Essential Duties and responsibilities: 1. Recruits, hires, manages and evaluates care management staff, inclusive of Nurses, Social Workers, and other care management staff (eg. Patient Engagement Coordinator, Community Health Navigator). Works with BILHPN clinical excellence team and BILHPN Risk Unit and primary care leadership to organize and assign the team to maintain adequate staffing levels. Develops and implements competencies and provides ongoing education. (essential) 2. Aligns and Directs work of team to BILHPN strategic priorities in order to achieve clinical and financial program goals and related outcome measures as developed by the Director of Network Care Management and Clinical Excellence Leaders. (essential) 3. Jointly develops programs and/or approaches that ensure effective case management and smooth transition of patients between care settings. This may include working with hospital, post acute, and community care management representatives within and external to BILH. Also coordinates medical management and delegation activities with new provider groups to ensure compliance with agreements. Coordinates care management activities within risk unit and primary care offices to ensure programmatic integrity, specialty services and off site case management. (essential) 4. Oversees agreements with payers and provider groups to conduct case management using specified registries and web applications. Ensures that required performance measures are achieved and maintained. Works with PCPs to ensure appropriate coordination of care of identified risk patients / members. (essential) 5. Initiates mechanisms for working with representatives of payer organizations to achieve mutual goals of quality, cost effective care. Participates in developing responses to new contracts and contract changes. Develops a program for working with health plan nurse case managers. (essential) 6. Follows trends in care management of special populations or disease management of specified chronic illnesses. Recommends incorporation of programs to BILHPN Director of Network Care Management or Clinical Excellence Leaders required. (essential) 7. Has the authority to direct and support employees daily work activities. Has the direct responsibility to undertake the following employment actions: hiring, termination, corrective action and performance reviews. Direct Reports: More than 7 Indirect Reports: 1-5 9. Assists in planning, monitoring and/or managing budget in functional area of department. Job Description: Education : BSN required, MSN Preferred Licensure, Certification & Registration : RN Case Management Certification (CCM preferred) Experience : 5-8 years related work experience required within Population Health, Ambulatory focused Care Management. 5 – 8 years related work experience required within ACO, and/or managed care or commercial payors. 1-3 years supervisory/management experience required. Skills, Knowledge & Abilities : Strong development, analytic and systems building skills. Must be facile with physician relations, developing systems and procedures, developing and operating a capitated managed care infrastructure, continuous quality improvement, human resources management and fiscal management. Excellent written and verbal communication skills. Must have a professional demeanor and the ability to deal with physicians, senior management, and local industry. Capable of serving as a spokesperson and leader of the integration process and communicate the vision to others in the community. A well-defined style that demonstrates confidence, maturity, self-motivation, high energy, collaboration, high intellect and leadership qualities. Excellent interpersonal skills, be an appropriate risk taker, politically savvy, diplomatic, able to deal with ambiguity, flexible, organized, results oriented, a hard worker, a quick study, good with details and have integrity. Ability to function as a facilitator who can further the organization to serve the evolving Network. Strong clinical background. Experience in managed care, community nursing, and outpatient case management, post acute care, quality measure gap closure, and disease management programs. Leadership experience in program and/or staff development. Advanced skills with Microsoft applications which may include Outlook, Word, Excel, PowerPoint or Access and other web- based applications. May produce complex documents, perform analysis and maintain databases. Working within EMR’s: Epic, ECW, OMR, Medi-tech, Athena, Arcadia Pay Range: $120,000.00 USD - $150,000.00 USD The pay range listed for this position is the annual base salary range the organization reasonably and in good faith expects to pay for this position at this time. Actual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law. As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) as a condition of employment. More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger. Equal Opportunity Employer/Veterans/Disabled $84,300.22 - $107,481.20 / year
Why Join Us? Newly adjusted Sign On Bonuses Recently increased market salaries Generous benefits that are effective day one Fleet car program: company paid vehicle, includes insurance, business miles and maintenance. Must meet eligibility requirements Company laptop and phone Job Overview Utilizing the nursing process, the Home Health Registered Nurse will manage and deliver comprehensive home health services, including assessments, interventions, and supportive care to clients within their place of residence. Depending on the circumstances, duties may also include telephone triage, problem solving, patient/caregiver advocacy and support, with emphasis of avoiding hospitalization. As a key member of the health care team, this position must interact courteously and effectively with patients and their families as well as with coworkers from all Agency departments, community resources, and with patients' physicians in order to facilitate safe and efficient patient care while maintaining their own safety in the home and the community at large. Location: We’re looking for compassionate, reliable caregivers across multiple service territories, including Greater Lowell, Merrimack Valley, Essex County, North Shore, and surrounding communities, as well as territories in New Hampshire, including Merrimack Country, Hillsborough County and Rockingham County Hours: Full-Time, Days, 40 Hours Minimum Qualifications: 1. Massachusetts/New Hampshire RN Licensure. 2. Valid state issued Driver’s License. 3. One (1) year of acute medical/surgical nursing experience. 4. Cardiopulmonary Resuscitation (CPR) Certification. Duties and Responsibilities: The duties and responsibilities listed below are intended to describe the general nature of work and are not intended to be an all-inclusive list. Other duties and responsibilities may be assigned. Essential Functions: Assesses patients' physical, psychosocial needs in a sensitive, caring manner following established Standards of Nursing Practice and VNA procedures. Assesses patient/family learning needs, style and limitations and adjusts for delivery of information. Establishes realistic goals and develops plans of treatment in cooperation with the patient, family and members of the health care team. Adapts to new and unusual situations without affecting work performance negatively. Utilizes Security when and if needed for any potential unsafe situations. Collaborates with patient /family and other health care providers and/or community resources with planning of care and discharge. Completes physicians' orders, levels of care, and OASIS on all patients assigned, in accordance with patient care policies. Reconciles medications with patient and physician consistently. Demonstrates ability to cope with patient/family emotional stress and provide appropriate supportive care. Effectively manages assigned caseload, within the team model of care delivery. Establishes a daily work plan based upon patient/family priorities of service and total area needs. Promptly triages patient visits, messages, and phone calls according to priority and urgency. Demonstrates excellent physical assessment and care planning skills. Demonstrates current knowledge of pharmacology and medication administration and reconciliation. Demonstrates ability to cope with patient/family emotional stress and provide appropriate supportive care. Effectively manages assigned caseload, within the team model of care delivery. Establishes a daily work plan based upon patient/family priorities of service and total area needs. Promptly triages patient visits, messages, and phone calls according to priority and urgency. Coordinates care and discharge planning with other team members during case conferences. Acquires and maintains an expert working knowledge of all third part payers and regulatory bodies and agency policies on issues related to documentation and care provided. Communicates and collaborates with all disciplines in the home care setting on a regular basis or immediately if there are any critical needs or crisis interventions needed. What We Offer: Competitive salaries & benefits that start on day one! 403(b) retirement with company match Tuition reimbursement Fleet Car Program About Care at Home: Tufts Medicine Care at Home is a proud member of Tufts Medicine, a health system that is rethinking how academic and community centers, local and national businesses, and technology and service innovators can all work together. So that clinicians can deliver expert care where it’s needed most and so that we can bring wellness back to health care, one person at a time. About Tufts Medicine A healthcare system that works Tufts Medicine is more than a health system — we’re a community that empowers people to live their best lives by reimagining healthcare, advancing knowledge and pioneering discovery. Every team member plays an integral role in realizing our vision of creating the most equitable and frictionless healthcare experience in the world. Here, you’ll join an enthusiastic community that champions your growth and receive generous benefits to support you and your family’s well-being. Tufts Medicine is an equal opportunity employer At Tufts Medicine, we want every individual to feel valued for the skills and experience they bring. Our compensation philosophy is designed to offer fair, competitive pay that attracts, retains, and motivates highly talented individuals, while rewarding the important work you do every day. The base pay ranges reflect the minimum qualifications for the role. Individual offers are determined using a comprehensive approach that considers relevant experience, certifications, education, skills, and internal equity to ensure compensation is fair, consistent, and aligned with our business goals. Beyond base pay, Tufts Medicine provides a comprehensive Total Rewards package that supports your health, financial security, and career growth—one of the many ways we invest in you so you can thrive both at work and outside of it. Pay Range : $84,300.22 - $107,481.20 
Overview Associate or bachelors degree in nursing. One year of clinical RN experience in home health or hospice. One year of RN management experience. Current RN license, specific to the state(s) you are assigned to work. Current CPR certification. Our compensation reflects the cost of labor across several U.S. geographic markets and may vary depending on location, job-related knowledge, skills , and experience. 
