RN Clinical Care Manager - Elevate Patient Outcomes

Blue Cross and Blue Shield of Massachusetts, Inc.; Hingham (MA); On-site; USD 60,779 - 74,293; 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. seeks a Clinical Care Manager in Hingham to coordinate care for members with rising health risks or complex needs. The role emphasizes assessment, plan development, and education to promote optimal health outcomes.

Work is performed in a self-directed, collaborative environment with a team of medical and behavioral health professionals. Massachusetts licensure (RN/LMHC/LISW/LCSW) is required, with BSN preferred for RN track, and robust experience in

Qualifications

• Excellent written and verbal communication; able to document clearly.
• Self-directed and able to collaborate within a multidisciplinary team.
• Experience with case management processes and regulatory standards.
• Ability to assess complex medical information and create care plans.
• Experience with culturally diverse populations and health disparities.

Responsibilities

• Assess member and family needs; develop and update care plans.
• Promote adherence to treatment plans and shared decision-making.
• Document criteria, processes, and policies for care management.
• Educate members on medications, side effects, and mitigation strategies.
• Engage members to ensure seamless care transitions and outcomes.
• Coordinate with clinicians, physicians, and providers for care.
• Gather clinical information from providers to support the plan of care.
• Identify quality concerns and refer appropriately.

Skills

Communication skills

Self-directed

Collaboration

IT systems

Goal setting

Clinical decision making

Education

Massachusetts licensure (RN/LMHC/LICSW/LCSW)

BSN preferred for RN track

Tools

Case management software

Job description

Blue Cross Blue Shield of Massachusetts, Inc. seeks a Clinical Care Manager in Hingham to coordinate care for members with rising health risks or complex needs. The role emphasizes assessment, plan development, and education to promote optimal health outcomes.

Work is performed in a self-directed, collaborative environment with a team of medical and behavioral health professionals. Massachusetts licensure (RN/LMHC/LISW/LCSW) is required, with BSN preferred for RN track, and robust experience in