Office Based Opioid Treatment - Registered Nurse

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General Description

 The OBOT (Office-Based Opioid Treatment) RN Case Manager will provide skilled nursing care, case management and coordination of the plan of care for those Brien Center clients who are being treated for opioid use disorder. In close collaboration with the buprenorphine certified physicians, in-house behavioral health providers and our partners in the community, the RN Case Manager will provide and coordinate the daily and long term care of clients in recovery.


  • Determine patient eligibility to participate in OBOT and initiate intake, under the direction of the physician, if patient meets the clinical guidelines
  • Provide direct patient care (60 to 75% of the workload) within the scope of the RN license. In addition to addiction treatment monitoring (regular interaction with behavioral health, urine drug screen tracking), the OBOT RN manager will be expected to coordinate screening to track chronic disease measures while working closely with the primary care team.
  • Assist in the development of clinical policies and patient flow design, with particular attention to protocols around screening, risk stratification and separation of clients for repeated breach of sobriety and care plan.
  • Facilitate induction, stabilization and maintenance phases of the OBOT program
  • Administer Clinical Opioid Withdrawal Scale
  • Witness ingestion of medication
  • Administer injectable naltrexone
  • Assess client’s current needs and treatment, consulting with the prescriber about the need for high risk interventions, prescription and referrals to other medical providers if warranted and for other services within the Brien Center.
  • Document patient encounters within 24 hours in EMR.
  • Monitor results of witnessed urine toxicology and alert OBOT MDs of findings
  • Create attendance, toxicology and other outcome reports for ongoing QI monitoring
  • Facilitate communication between OBOT and other treatment providers at the Brien Center and in the community
  • Participate in developing the workflow for communication with PCPs as well as with  buprenorphine certified physicians
  • The nurse case manager will participate in training and technical assistance activities provided via BSAS contract.


  • Ensure documentation is clear, objective, timely and reflects the delivery of safe, quality care.
  • Establish and maintain an ongoing positive working relationship with all members of the care team, facilitating quality treatment planning
  • Participate in Medication Clinics
  • Communicate regularly with primary care providers to coordinate treatment
  • Monitor client medications and side effects
  • Assist clients in applying for Mass Health assistance/Medicare D – refer to Advocacy for Access
  • Provide education for clients on medications, side effects, health issues and wellness
  • Take and monitor client vital signs when necessary
  • Schedule walk-in clinics for no show/cancelled appointments
  • Perform medication counts
  • Monitor medical related incidents
  • Monitor lab levels
  • Coordinate psychiatric schedules ensuring the prioritizing of those clients with immediate needs
  • Complete prior approval forms for medication and submit to prescriber for review and signature
  • Telephone contact and conferencing with pharmacies, primary care clinicians, hospitals, service programs and significant members of a client’s social network (with signed release)  regarding medication regimes, side effects and desired effects of medication
  • Serve as liaison to pharmacies
  • Monitor completion of annual physicals
  • Attend in all required staff meetings, trainings and supervisions
  • Comply with all Brien Center policies and procedures
  • Flexibly respond to program scheduling needs
  • Represent the agency in a professional manner in all community contacts

The description above represents the most significant duties of this position but does not exclude other occasional work assignments not mentioned, the inclusion of which would be similar to those outlined above.


  • RN with current MA license
  • Possess and maintain the Healthcare Provider (BLS) level of CPR or obtain within the first 5 months of employment
  • Case management experience strongly preferred with experience in substance use disorder treatment services
  • Computer literate and proficient in Microsoft Office applications (Excel and Word)
  • Either trained in evidenced based models or agreeable to training in motivational enhanced training, recovery model, 12 Step facilitation


  • Skill and knowledge in the principles and practices of psychiatric/community behavioral health nursing
  • Sound knowledge of normal personality growth and development
  • Knowledge and experience in theory, principle and practices of crisis intervention
  • Knowledge and skill in the use of psychotropic medications
  • Proven skills and knowledge base necessary for clinical decision making and care delivery
  • Strong analytical, problem solving, planning and prioritization skills
  • Extremely detail-oriented in both verifying own work as well as the work of others
  • Experience in case coordination: ability to objectively assess clients and advocate for needed treatment, effectively work with local physicians and their staffs, oversee implementation of medical recommendations
  • Ability and propensity to work with a culturally diverse population with a range of psychiatric disabilities


  • Manual & Visual Dexterity; correctable
  • Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions.


  • Works in office; temperature regulated
  • Facilitate groups in other community locations
Location: Full time in Pittsfield and North Adams, MA
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