Case Management Nurse

Job Title

Outpatient Nurse Care Manager

Location:

Westfield, MA

Schedule:

Part Time – 24 hours per week
Standard

Hours:

24 / Exempt

Shift: Shift 1

Reports to:

Program Manager for Care Management

• Manage complex patients in risk contracts, overseeing care management, disease management, transitions of care, and care coordination.
• Accurately identify patients for care management through provider referrals, transitions of care, health plan lists, and ACO complex lists.
• Develop individualized care plans, provide education, perform medication reconciliation and titration, and ensure adherence to quality measures.
• Provide disease/complex care management face‑to‑face or via phone, and conduct home visits when appropriate.
• Manage transitions of care: review discharge summaries, verify pending testing, confirm ordered services, perform medication reconciliation, and assess further care management needs.
• Assist with advance directives, referrals to palliative care/hospice, and end‑of‑life care coordination.
• Oversee population management activities with Care Coordinators, addressing quality indicators out of range and helping patients reach targets.
• Maintain documentation in patient medical records or care management applications.
• Review program metrics (total medical expenses, ER utilization, admissions/readmissions) to evaluate program impact.
• Remain current on care management knowledge, community resources, and quality improvement methodologies.

• Associate Degree in Nursing (minimum);
  Bachelor’s Degree in Nursing preferred.
• Minimum five years of experience as a Registered Nurse; preferred 2–3 years of care management experience.
• MA Registered Nurse license.
• Driver’s license.
• CPR certification.
• Strong communication, interpersonal, and problem‑solving skills.
• Excellent organization and prioritization skills.
• Attention to detail and ability to work independently.
• Knowledge of population management, community resources, and quality improvement.

• Strong communication and interpersonal skills to advocate for optimal patient outcomes.
• Ability to work closely with patients, providers, office staff, and managed care plans.
• Strong organizational and prioritization abilities.
• Detail‑oriented with independent work capability.

• Low‑cost medical, dental, and vision plans for employees and eligible dependents.
• Wellness reimbursements for gym membership, equipment, personal trainer, and massage.
• 401(k) plan with employer contributions.
• Competitive paid time off.
• Tuition reimbursement for eligible employees.
• Fully company‑paid life insurance and short‑ and long‑term disability coverage.
• Recognition programs and a collaborative work culture.

Baycare Health Partners Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, ancestry, age, genetic information, disability, or protected veteran status.