Register Nurse Care Manager - Middlesex /Worcester County - Hybrid
Core
Manages a panel of clinically complex members to support clinical programs, quality gap initiatives, and ED/IP utilization by creating care plans and coordinating with integrated and external providers.
Role type
Senior Registered Nurse Care Manager
Builds
Clinical care pathways and quality improvement outcomes for members with chronic diseases and behavioral health needs
Domain
Healthcare / Population Health Management
Required skills
Clinical judgment, medication reconciliation, care plan development, behavioral health screening, case conference leadership, quality gap closure, ICD/CPT coding, electronic health records utilization
Preferred skills
Motivational Interviewing, Trauma-Informed Care, critical thinking, creative problem solving
Technologies
Electronic health records, scheduling platforms, care facilitation tools
Responsibilities
Conduct in-person clinical examinations and regular follow-ups; perform medication reconciliation and administration; address social needs with community partners; lead case conferences; ensure thorough chart documentation and coding; support transitions of care between inpatient and ED settings
Seniority
Senior, hands-on IC