RN Clinical Care Manager
- Salary
- $90K–$110K
- Hiring from
- United States
- Work type
- Hybrid
- Posted
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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.
Mass General Brigham Health Plan seeks a Registered Nurse (RN) Clinical Care Manager to work as part of an interdisciplinary care team providing care management for health plan enrollees with complex medical, behavioral, and social needs, including Severe and Persistent Mental Illness (SPMI).
As a clinical expert on the interdisciplinary team, the Clinical Care Manager conducts assessments, develops member-centered care plans, coordinates care, provides health education, and collaborates with providers to ensure comprehensive support.
This position requires an active RN license and a hybrid working model, including practice-based, remote work, and member in-person home and community visits as needed.
The population will primarily include enrollees residing in Essex, Middlesex, Suffolk, Norfolk, Plymouth, Bristol, Dukes, and Nantucket counties. The Clinical Manager's responsibilities and caseload may be adjusted based on enrollee enrollment trends.
Essential Functions:
-Collaborate with the interdisciplinary care team—including LTSC, GSSC, primary care providers, and specialists—to support program enhancements, process improvements, and comprehensive care coordination.
-Participate in interdisciplinary care team meetings, ensuring medication reconciliation, timely follow-ups after hospitalization, quality gap closures, and consistent communication with providers and enrollees.
-Develop, update, and implement individualized, enrollee-centered care plans in collaboration with enrollees and the care team, incorporating self-care, shared decision-making, and addressing behavioral health needs.
-Conduct outreach, assessments, and home visits using telephonic, electronic, or in-person methods to evaluate clinical status, identify needs, and provide ongoing community-based care management or appropriate referrals.
-Monitor members’ clinical status for early signs of deterioration, proactively intervene to prevent unnecessary hospitalizations, and act as the clinical escalation point for urgent issues through triage, telephonic support, and care coordination.
-Provide health education, coaching, and routine engagement to assigned enrollees, proactively addressing questions, concerns, and facilitating access to providers and supportive services.
-Utilize electronic medical record systems to accurately document, monitor, and evaluate enrollee interventions and care plans, ensuring compliance with DSNP regulations and internal policies.
-Serve as a clinical resource and lead interdisciplinary care team member for assigned enrollees, supporting compliance initiatives, quality assurance, and collaborating with care management leadership on challenging cases.
-Perform additional duties as assigned by supervisors to support care management goals and promote enrollee well-being.
Qualifications
Qualifications
- Associate's Degree Nursing required; Bachelor's Degree Nursing preferred
- Massachusetts Registered Nurse (RN) license required
- At least 2-3 years experience in health plan or community case management highly preferred
- Experience with Dual Eligible Populations (Medicare and Medicaid) preferred
- Certified Case Management Certification preferred
Skills for Success
- Exceptional communication abilities with active listening skills
- 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 Model Required
- This is a full-time position with a schedule of Monday through Friday, 8:30 AM-5:00 PM EDT
- This is a hybrid schedule, which includes practice-based work, remote work, and in-person home and community visits (these days will vary weekly, and these visits may increase as member trends evolve)
- Must be local, ideally in Eastern, MA, with the ability to travel to the community.
- This role offers autonomy to build own schedule to accommodate members’ needs.
- Remote working days require a stable, quiet, secure, compliant working station and access to Teams Video via MGB equipment
Our goal will be to geographically align employees; this depends on residence and can vary based on business needs, member enrollment, and team staffing.Employees must accommodate the hybrid work model, including practice-based work, remote work, and in-person home and community visits with members.
The member population will reside primarily in Norfolk, Plymouth, Bristol, Dukes, and Nantucket counties. The responsibilities and caseload may be adjusted based on enrollment trends.
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Scheduled Weekly Hours
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Pay Range
$58,656.00 - $142,448.80/Annual
Grade
98TEMP
EEO Statement:
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.
Why work here?
Combat disease. Hold a hand. Help people. Impact the world.
Mass General Brigham is a passionate, welcoming community where minds meet caring hearts.
Come be a part of the world’s most powerful force in medicine, where every role is important in changing lives. Are you ready?
About Us?
Our history includes New England hospitals founded over 200 years ago, some of the first and most prestigious hospitals in the world.
Built on the legacy of two leading academic medical centers, we’re more than a system—we’re leaders in the practice of medicine. Mass General Brigham is committed to serving the community.
We are dedicated to enhancing patient care, teaching and research, and taking a leadership role as an integrated health care system.
We recognize that increasing value and continuously improving quality are essential to maintaining excellence.
