Remote Clinical Care Manager: Holistic Care & Coordination

WellSense Health Plan; Massachusetts; Remote; USD 74,000 - 107,000; Full time

Benefits offered by this job

Remote work

Competitive salary

Job summary

WellSense Health Plan is seeking a Clinical Care Manager to provide holistic medical care management for members across the care continuum, collaborating with a multidisciplinary team to improve outcomes and reduce costs. This is a full-time remote position based in Massachusetts.

You will assess readiness for behavioral changes, develop individualized care plans, coordinate services, and guide members through access to benefits, while documenting in real-time and adhering to HIPAA and NCQA

Qualifications

• BSN or ADN with relevant work experience.
• 3 years in home health care or managed care.
• 3 years in care management, care coordination or discharge planning.
• Unrestricted nursing license or licensed social worker preferred.
• CCM certification preferred.

Responsibilities

• Assess members and develop individual care plans.
• Coordinate care across providers and settings.
• Support access to benefits and resources.
• Document care management activities in real-time.
• Coordinate with multidisciplinary team.

Skills

Motivational Interviewing

Communication

Collaboration

EMR Documentation

MS Office

Education

Bachelor’s degree in nursing

Associate’s degree in nursing

Tools

FACETS

CCMS

InterQual

Job description

WellSense Health Plan is seeking a Clinical Care Manager to provide holistic medical care management for members across the care continuum, collaborating with a multidisciplinary team to improve outcomes and reduce costs. This is a full-time remote position based in Massachusetts.

You will assess readiness for behavioral changes, develop individualized care plans, coordinate services, and guide members through access to benefits, while documenting in real-time and adhering to HIPAA and NCQA