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Title

Care Manager 

EOE StatementWe are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law.
 
About the Organization The mission of Fenway Health is to enhance the wellbeing of the lesbian, gay, bisexual, and transgender (LGBTQIA+) community and all people in our neighborhoods and beyond through access to the highest quality health care, education, research, and advocacy. Fenway Health was founded in 1971 and has grown from a less than 10 person operation in the basement of a building near the Boston Fens to one of the largest LGBT-focused organizations in the world. It consists of three main centers:



• Fenway Community Health Center, our clinical arm, which is a federally qualified health center that operates three clinic sites (Fenway:1340, Fenway:South End, and the Sidney Borum, Jr. Health Center) in the Boston area and provides over 30,000 patients with primary and specialty medical care, behavioral health care, optometry care, and dental care;



• The Fenway Institute, our research/training/education/policy development arm, which houses numerous research initiatives as well as the National LGBT Education Project, the LGBT Aging Project, the National Center for Innovation in HIV Care, and the Center for Population Research in LGBT Health; and



• AIDS Action, our HIV/AIDS service organization, which provides nonclinical services (case management, housing and legal assistance, outreach, peer support) to people living with HIV/AIDS and operates numerous programs focusing on HIV/STD prevention/testing/treatment, including the Access (drug user health program), TransCEND (transgender peer support and risk reduction program), and Youth on Fire (drop-in center for homeless and street-involved youth) programs.

 
Position Care Manager  
Full-Time/Part-Time Full-Time  
Description

Position Summary
Reporting to the Medical Director, the Fenway Health Care Manager (1) plans all administrative Patient-Centered Medical Home activities within the Fenway Health Medical Department and (2) oversees care management of transitional and high risk patients by team RN's. The Care Manager's main goal is to ensure that primary care providers (PCP's) maintain a central role in coordinating and managing the care of their patients.

Principal Duties and Responsibilities

  1. Patient-Centered Medical Home Administration
  • Trains all team members in the coordination and provision of patient-centered care.
  • Works with the Director of Government Affairs, the Director of Quality Improvement, and the Patient-Centered Medical Home Data Team Member to prepare Patient-Centered Medical Home related data reports, progress reports, and funding applications.
  • Reviews Patient-Centered Medical Home progress with the Medical Director and the Management Team (as needed).
  • Facilitates Patient-Centered Medical Home Care Team meetings and prepares action plans for care teams in follow-up to these meetings. A Patient-Centered Medical Home Care Team will consist of at least the following: a physician, a medical assistant, a team RN, and a team LPN.
  • Serves as the liaison between Patient-Centered Medical Home Care Teams and all outside care entities with whom these care teams work.
  • Oversees development, maintenance, and distribution of all Patient-Centered Medical Home tracking systems, including:
  1. Oversees Care Management of Transitional or High Risk Patients by Team RN's
  • Transitional patients include those patients who are admitted to and discharged from the hospital, seen in and discharged from the emergency room, or transitioning to or from any other health care facility.
  • High risk patients are determined by characteristics such as severity of disease, self-care limitations, lack of family support, severe socioeconomic factors, polypharmacy, and health care utilization trends
  1. Provides appropriate and timely documentation of clinical work
  • Maintains patient records in a timely manner in the electronic medical record
  • Completes forms and reports for insurance companies and other agencies, as needed
  1. Continues professional development activities
  • Completes minimum CEU requirements
  • Participates in educational conferences with other clinic staff
  • Participates in outreach programs
  1. Meets agency participatory expectations
  • Adheres to all agency and departmental policies and procedures
  • Participates in quality assessment and improvement activities as requested
  • Adheres to the highest principles of patient and client confidentiality
  • Adheres to established safety policies, procedures and precautions; identifies potential or actual unsafe situations in the environment and takes measures to rectify the situation
  • Attends all required meetings, in-services and professional training
  • Maintains professional competence necessary to perform job responsibilities; maintains and provides agency with records of continuing education activities
  • Serves on agency committees and in professional organizations when requested

We offer competitive salaries, and for those who qualify, an excellent benefits package; including comprehensive medical and dental insurance plans, and a retirement plan with employer match. We also provide 11 paid holidays, paid vacation, and more.
LGBTQ-identified persons, people of color, and others from historically underrepresented communities are encouraged to apply.

 
Number of Openings 1  
Position Requirements

Required Knowledge, Experience, or Licensure/Registration

  1. Education: Registered Nurse degree (minimum)
  2. Experience in case management, disease management, home health care nursing, hospital nursing, or intensive outpatient education and self-management support.
  3. Experience in all of the following
  • Comprehensive nursing assessment, problem identification, and care plan development
  • Disease management
  • Screening for developmental issues, depression, other psychological conditions, and frailty
  • Clinical system design and development
  • Project management
  • Behavioral strategies including motivational interviewing and self-management support
  • Relationship building with patients, staff, and providers
  • Management of staff
  • Documentation in an electronic medical record
  • Computer skills including MS Excel, Word, and PowerPoint
  1. Current Massachusetts license

Working Conditions and Physical Requirements

  1. OSHA Category 1: involves exposure to blood, body fluids, or tissues
  2. Physical Requirements
  • Regularly required: sitting; using hands to manipulate objects/tools/controls; reaching with hands and arms; talking; hearing
  • Frequently required: lifting and/or moving up to 10 lbs.
  • Occasional required: lifting and/or moving up to 25 lbs.
  • Vision abilities required: close vision, distance vision, peripheral vision depth perception, ability to adjust focus
  1. Noise Level: usually quiet
 
Category Nursing  
Number Filled 0  
Location Medical - Ansin Building  
Shift Days  
Req Number NUR-19-00022  

This position is currently accepting applications.

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