Cardiac Nurse Case Manager

Mass General Brigham Health Plan
United States, Massachusetts, Somerville
399 Revolution Drive (Show on map)
Mar 05, 2025
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 cardiac 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. Essential Functions -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. Qualifications: Associate's Degree Nursing required or Bachelor's Degree Nursing preferred MA Registered Nurse License required Basic Life Support [BLS] Certification required Case management, utilization review, or discharge planning experience required Cardiac experience highly preferred At least 2-3 years of experience preferred Knowledge, Skills, and Abilities 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. Knowledge of Healthcare and Managed Care preferred. Physical Requirements Standing Frequently (34-66%) Walking Frequently (34-66%) Sitting Occasionally (3-33%) Lifting Frequently (34-66%) 35lbs+ (w/assisted device) Carrying Frequently (34-66%) 20lbs - 35lbs Pushing Occasionally (3-33%) Pulling Occasionally (3-33%) Climbing Rarely (Less than 2%) Balancing Frequently (34-66%) Stooping Occasionally (3-33%) Kneeling Occasionally (3-33%) Crouching Occasionally (3-33%) Crawling Rarely (Less than 2%) Reaching Frequently (34-66%) Gross Manipulation (Handling) Frequently (34-66%) Fine Manipulation (Fingering) Frequently (34-66%) Feeling Constantly (67-100%) Foot Use Rarely (Less than 2%) Vision - Far Constantly (67-100%) Vision - Near Constantly (67-100%) Talking Constantly (67-100%) Hearing Constantly (67-100%) Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.