About the role

Registered Nurse Case Manager providing comprehensive care for patients in Boston North Shore area. Collaborating with teams to ensure quality patient outcomes and effective care coordination.

Responsibilities

Manage a diverse caseload, ensuring quality patient care and efficient care coordination.
Provide coaching, oversight, and support to Home Health Aides (HHAs) to ensure high-quality patient care and adherence to clinical standards.
Develop and implement individualized care plans based on patient assessments and goals.
Coordinate with PCPs, therapy providers, and internal support teams to ensure comprehensive care.
Provide education and support to patients and families regarding their health care needs and treatment plans.
Maintain accurate and timely electronic charting, with a preference for real-time documentation.
Ensure all documentation meets regulatory and Abby Care standards, with a minimum of 24-hour turnaround time.
Establish and maintain effective communication with PCPs, therapy providers, and internal support teams.
Escalate appropriate issues to Clinical Leads in a timely manner, such as order management and patient concerns.
Participate in on-call rotation (approximately one weekend per month), holiday rotation, and possible phone triage night coverage during weekdays.
Achieve caregiver satisfaction by providing high-quality, compassionate care and support.
Monitor and work to improve patient readmission rates.
Ensure extended visits remain within acceptable ranges and administrative tasks (e.g., mileage reimbursements) are completed thoroughly.

An Associate's Degree or A Baccalaureate School of Nursing Degree.
Current and valid license as a Registered Nurse in the state of Massachusetts.
2 years of experience as a Registered Nurse in a clinical setting; 1 year of home health experience preferred.
Case management/supervisor experience and pediatric/adult care experience preferred.
Knowledge of Medicaid paid family caregiving program and HHA scope of practice preferred (training provided if needed).
Reliable transportation, valid driver's license, and current auto insurance required.
Ability to work flexible hours, travel locally, and provide on-call service to patients/families.
Knowledge of OASIS preferred (training provided if needed).

Competitive compensation packages that reflect the value you bring. We reward our team for the impact of their work – full-time employees are eligible for an annual company performance bonus.
Comprehensive health coverage that works for you. We cover 90% of your premiums and 70% for your dependents, with multiple PPO plan options to choose from for medical, vision, dental, life, and short-term disability.
Generous paid time off. We provide policies that allow you to recharge along with 10 paid company holidays.
Team bonding. We love bringing our teams together. As a full-time employee, you’ll get to connect, collaborate, and have fun through team activities and our annual company retreat.
Financial savings benefits to support your future. We support your financial well-being with HSA contributions, optional FSA and commuter benefits, and full coverage of all 401(k) account fees (employer match not currently offered).
Paid parental leave to support your growing family. We provide paid leave, so you can focus on bonding and adjusting to life as your family grows.