Asthma Nurse Case Manager

Mass General Brigham Health Plan; Somerville (MA); Hybrid; USD 90,000 - 110,000; Full time

Job summary

Mass General Brigham Health Plan is hiring a Nurse Care Manager to conduct telephonic care management for members with respiratory conditions, identify high-risk members, and collaborate with providers and families to improve health outcomes. The role emphasizes NCQA-compliant documentation and care planning in a supportive, mission-driven environment.

The position is full-time in a hybrid setting with on-site presence roughly once per quarter at Assembly Row, Somerville, and a typical 8:30–5:00

Qualifications

• Associate's Degree Nursing required.
• Bachelor's Degree Nursing preferred.
• Massachusetts RN license required; BLS certification required.

Responsibilities

• Client assessments and planning.
• Documents in member EMR per NCQA.
• Modify member treatment plans.
• Define care goals for cardiac patients and families.
• Coordinate member care with the team as needed.
• Review cases with medical directors as needed.
• Maintain accurate, detailed reports and records.

Skills

Case management

Utilization review

Discharge planning

RN background

Communication

Microsoft Office

Education

Associate's Degree Nursing

Bachelor's Degree Nursing preferred

Tools

EMR systems

Microsoft Office

Job description

Site: Mass General Brigham Health Plan Holding Company, Inc.

Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

Job Summary

Given equity, this position will pay somewhere between $90,000 to $110,000 annually.

Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are at the forefront of transformation with one of the world's leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage.

Our work centers on creating an exceptional member experience - a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a welcoming and supportive environment that embraces their unique and varied backgrounds, experiences, and skills.

We are pleased to offer competitive salaries and a benefits package with flexible work options, career growth opportunities, and much more.

Serves as a member of the Coordinated Whole Health Care team at Mass General Brigham Health Plan, the Nurse Care Manager conducts telephonic care disease management for members with respiratory (i.e. asthma, COPD, etc.) conditions. The Nurse Care Manager outreaches and works with members identified as higher risk. This includes partnering with members, providers, and families to create care plans that provide strategies to improve member health outcomes and help members meet self-identified health management goals.

Essential Functions

• Client Assessments and Planning
• Documents in accordance with NCQA requirements in member EMR
• Modify member treatment plans
• Defines care goals of cardiac patients by providing education, information, and direction to each individual and family
• Coordinates member care with other members of the Coordinated Whole Health Care team when appropriate
• Review cases with medical directors on challenging cases as needed
• Maintain accurate, detailed reports and records.

Qualifications

Education

• Associate's Degree Nursing required
• Bachelor's Degree Nursing preferred

Licenses and Credentials

• Massachusetts Registered Nurse (RN) license required
• Basic Life Support (BLS) certification required
• Respiratory experience highly preferred
• Previous teleophonic case management or home care experience highly preferred

Experience

• At least 2-3 years of case management, utilization review, or discharge planning experience preferred

Knowledge, Skills, and Abilities

• Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.
• Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions, or approaches to problems.
• Ability to establish strong rapport and relationships with patients and staff.
• Proficient in Microsoft Office and industry-related software programs.
• Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions.
• Ability to maintain client and staff confidentiality.
• Understanding of diagnostic criteria for dual conditions and the ability to conceptualize modalities and placement criteria within the continuum of care.
• Knowledge of Healthcare and Managed Care preferred.

Additional Job Details (if applicable)

Working Conditions

• This is a hybrid role that requires an on-site presence at the office in Assembly Row, Somerville roughly once per quarter
• This is a full-time role with a Monday through Friday schedule, generally 8:30-5:00 PM Eastern Time
• Remote workspace requirements, including privacy and security standards, may be verified in accordance with organizational policy

Given equity, this position will pay somewhere between $90,000 to $110,000 annually.

Remote Type

Hybrid

Work Location

399 Revolution Drive

Scheduled Weekly Hours

40

Employee Type

Regular

Work Shift

Day (United States of America)

Pay Range

$58,656.00 - $142,448.80/Annual

In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth.

EEO Statement:

8925 Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.

Mass General Brigham Competency Framework

At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.