Asthma Nurse Case Manager

Mass General Brigham•Somerville, MA

34d•$90,000 - $110,000•Hybrid

About The Position

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. Serves as a member of the Coordinated Whole Health Care team at Mass General Brigham Health Plan, the Nurse Care Manager conducts telephonic care disease management for members with respiratory (i.e. asthma, COPD, etc.) conditions. The Nurse Care Manager outreaches and works with members identified as higher risk. This includes partnering with members, providers, and families to create care plans that provide strategies to improve member health outcomes and help members meet self-identified health management goals.

Requirements

Associate's Degree Nursing required
Massachusetts Registered Nurse (RN) license required
Basic Life Support (BLS) certification required
Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.
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.

Nice To Haves

Bachelor's Degree Nursing preferred
Respiratory experience highly preferred
Previous teleophonic case management or home care experience highly preferred
At least 2-3 years of case management, utilization review, or discharge planning experience preferred
Knowledge of Healthcare and Managed Care preferred.

Responsibilities

Conducts telephonic care disease management for members with respiratory conditions.
Outreaches and works with members identified as higher risk.
Partners with members, providers, and families to create care plans.
Provides strategies to improve member health outcomes.
Helps members meet self-identified health management goals.
Documents in accordance with NCQA requirements in member EMR.
Modifies 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.
Reviews cases with medical directors on challenging cases as needed.
Maintains accurate, detailed reports and records.