Behavioral Health Case Manager — Drive Real Care Impact

Blue Cross and Blue Shield of Massachusetts Inc.; Hingham (MA); On-site; USD 56,000 - 68,000; Full time

Benefits offered by this job

Paid time off

Medical/dental/vision insurance

401(k)

Well-being benefits

Job summary

Blue Cross Blue Shield of Massachusetts Inc. in Hingham is seeking a Clinical Care Manager (Behavioral Health) to coordinate care for members with complex needs and rising health risks.

You will assess needs, develop and monitor care plans, and collaborate with a multidisciplinary team to promote optimal outcomes. This full-time role emphasizes evidence-based care, strong communication, and cultural competence, requiring MA licensure and 3–5 years of clinical experience.

Qualifications

• 3-5 years relevant clinical health care experience (inpatient, outpatient, or differing levels of care).
• Case Management experience preferred.
• Certifications such as CCM, certified diabetic educator, and Wellcoach certification a plus.
• Active licensure in Massachusetts appropriate to position (RN, LMHC, LICSW or LCSW).

Responsibilities

• Continually assess and evaluate member and family needs, using strong communication, critical thinking, clinical knowledge, data, and tools.
• Promote adherence to treatment plans and support shared decision-making and goal setting.
• Interpret and apply case management criteria, processes, policies, and regulatory standards to create and document care plans.
• Review medication lists, educate members with complex pharmacy needs, and counsel on side effects and mitigation strategies.
• Engage and collaborate with a multidisciplinary team to provide high-level care coordination.
• Interact with providers to gather clinical information supporting the plan of care.
• Monitor quality concerns, identify issues, and escalate as needed.

Skills

Communication

Critical thinking

Self-directed

Team collaboration

IT systems proficiency

Analytical reasoning

Cultural competence

Education

Active MA licensure (RN/LMHC/LICSW/LCSW)

BSN preferred for RN

Licensure in additional states a plus

Job description

Blue Cross Blue Shield of Massachusetts Inc. in Hingham is seeking a Clinical Care Manager (Behavioral Health) to coordinate care for members with complex needs and rising health risks.

You will assess needs, develop and monitor care plans, and collaborate with a multidisciplinary team to promote optimal outcomes. This full-time role emphasizes evidence-based care, strong communication, and cultural competence, requiring MA licensure and 3–5 years of clinical experience.