RN Case Manager: Cardiac & Chronic Care (Hybrid)

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

Job summary

Mass General Brigham Health Plan Holding Company, Inc. is seeking a qualified Registered Nurse for a hybrid case management role in Somerville.

The position emphasizes coordinating care for cardiac patients, developing education plans, and ensuring NCQA-compliant documentation in the member EMR. The ideal candidate has an RN license in MA, BLS, and 2–3 years of case management or discharge planning experience.

Qualifications

• Associate's Degree in Nursing required (MA RN license)
• Bachelor's Degree in Nursing preferred
• Massachusetts Registered Nurse (RN) license required; BLS certification required
• 2–3 years of case management, utilization review, or discharge planning experience preferred
• Proficient in Microsoft Office and related software; ability to document and communicate clearly

Responsibilities

• 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.

Skills

Communication

Rapport with patients

Confidentiality

Analytical thinking

Team collaboration

Education

Associate's Degree Nursing required

Bachelor's Degree Nursing preferred

Tools

Microsoft Office

Industry software

Job description

Mass General Brigham Health Plan Holding Company, Inc. is seeking a qualified Registered Nurse for a hybrid case management role in Somerville.

The position emphasizes coordinating care for cardiac patients, developing education plans, and ensuring NCQA-compliant documentation in the member EMR. The ideal candidate has an RN license in MA, BLS, and 2–3 years of case management or discharge planning experience.