Blue Cross Blue Shield Of Massachusetts
Healthcare
RNCaseManager
“RN Case Manager at Blue Cross Blue Shield Of Massachusetts. Skills: Care management, Case management, Member engagement, Health outcomes. Facilitating care for members and families with rising health risks or complex healthcare needs. Promoting optimal health”
What You'll Achieve.
Promote optimal health; Promote optimal member outcomes; Support seamless care transitions and optimized health outcomes
Industry & Context.
Assess needs; Identify health care disparities; Identify social determinants of health; Identify barriers to care; Identify and escalate quality of care issues
Any restrictions against a license must be disclosed and reviewed.
What They're Looking For.
Must Have
Active licensure in Massachusetts is required, appropriate to position (RN/PT)
Nice to Have
Utilization Management experience, Licensure in additional states a plus
What You'll Do.
Facilitating care for members and families with rising health risks or complex healthcare needs
Promoting optimal health
Engaging members in appropriate plans of care
Coordinating care and services
Communicating effectively
Providing members with education and resources
Promoting member compliance with treatment plan
Encouraging shared decision-making
Setting appropriate goals
Reviewing medication list
and maintaining member engagement
Interacting with treatment providers
Monitoring clinical quality concerns
Making referrals appropriately
Identifying and escalating quality of care issues
How You'll Work.
Team & Collaboration
Works independently and collaboratively; Part of a highly dedicated and motivated team of professionals, including medical and behavioral health care managers, dieticians, pharmacist, clinicians, medical directors and more, who collaborate to facilitate care.
Communication Scope
Communicate effectively
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