Commonwealth Care Alliance's (CCA) Clinical Care Manager is a registered nurse or other independently licensed behavioral health clinician responsible for providing intensive monitoring, follow-up and clinical care management to a panel of health plan members with complex medical, behavioral, and social care needs, including Severe and Persistent Mental illness.
As part of the care management dyad, the Clinical Care Manager works directly with assigned CCA members to help them navigate the health care system, gain access to available services, and assist members with finding answers to their questions.
The Clinical Care Manager functions as the clinical expert on an interdisciplinary team through close member oversight, routine and post discharge assessments, providing health education, and provider collaboration.
Consults, as needed, with other participants of the interdisciplinary care team on members experiencing medical or behavioral health issues.
Responsible for supporting the members in achieving their goals for independent living, recovery, and community connections.
This position allows for remote work, when possible, but does require in-person visits to members in their homes and community, as needed.
Supervision Exercised : No, this position does not have direct reports.Essential Duties & Responsibilities : * Complex care management* Care plan development, updates and implementation with members* Member education* Provider communication, including collaboration with DMH and DDS (BH)* Routine member engagement* Quality gap closures, including : * RN Clinical Care Manager* BH Clinical Care Manager* Medication Reconciliation* Follow up after Hospitalization (FUH)* Blood Pressure readings* Initiation and Engagement (IET)* Participate in interdisciplinary care team meetings* Performs applicable standardized assessments, including MDS, Comprehensive, Functional, and Crisis and Risk Assessments* Perform home visits with member for routine assessments, routine clinical needs, and post transitions of care follow up that require in person evaluations* Monitor available data for assigned members to inform proactive outreaches as well as reactive clinically appropriate assessments to ensure comprehensive knowledge of members current needs to inform continuous and meaningful updates to the care and service plan.
- Resource and expert for members regarding available benefits and resources to meet their needs.* Clinical resource for other members of the interdisciplinary care team* Additional duties as requested by supervisorWorking Conditions : * Standard office conditions* Must be able to travel to member's homes or other community environment* Must be able to come to the local CCA office and / or provider offices for various meetings as needed.
- Responsible to provide a strong internet connection when working remotelyRequired Education (must have) : * RN Clinical Care Managers must have : * Associate degree in nursing* Active RN license, in good standing, in state of assignment.
- BH Clinical Care Managers must have : * Master's degree in social work or mental health counseling and independent license* (LICSW or LMHC ) in good standing, in state of assignment.
Desired Education (nice to have) : * Bachelor's or Master's degree in nursing preferred* Other related Healthcare Degree* Certified Care Manager (CCM)MA Health Enrollment (required if licensed in Massachusetts) : * Yes, this is required if the incumbent is licensed in Massachusetts.
Required Experience (must have) : * Meaningful clinical and care management experience, including 3+ years caring for people with complex medical, behavioral and social needsDesired Experience (nice to have) : * Experience working in a health plan, with Medicare Advantage and / or dually eligible population* Experience with a care management platform (Guiding Care a plus)* Experience with Substance Use DisordersRequired Knowledge, Skills & Abilities (must have) : * Proven skills, knowledge base, and judgement necessary for independent clinical decision making in alignment with clinical licensure.
- Excellent critical thinking, organizational, time management and problem solving skills.* Ability to function independently and effectively as part of an interdisciplinary team* Strong and effective communication skills, both written and verbal* Strong interpersonal and customer relations skills* Strong customer service skills* Ability to work in multiple systems, often simultaneously.
- Flexibility to adapt to business needs* Motivated team player* High attention to detail and accuracyRequired Language (must have) : * EnglishDesired Knowledge, Skills, Abilities & Language (nice to have) : * Ability to utilize an Electronic Medical Record or other electronic platforms* Ability to use on-line training platforms* Demonstrated ability to utilize virtual care platforms* Proficiency in Microsoft Office Suite* Bilingual preferred
Registered Nurse (RN) - Ambulatory Care - $35 per hour
This triage role is 90% on the phones with patients with 10% hands on work administering vaccines! Qualifications · Must be a licensed RN in Massachusetts · For newly licensed nurses a Bachelor of Science Degree in Nursing is required · At least 2 years of experience as a RN preferred · Electronic M...
Unit Manager (Registered Nurse/RN)
The RN Unit Manager is responsible for supervising, implementing, coordinating, and managing patient care through interpersonal contact with patients, families, nursing staff, and others on his/her respective unit in accordance with all applicable laws, regulations, and Life Care standards. Displays...
Registered Nurse (RN) - PACU - Post Anesthesia Care - $35 per hour
Brigham and Women’s Hospital I CARE Standards The I CARE Standards guide me in my interactions with patients, family members, visitors, colleagues, and neighbors in my workplace and surrounding community to optimize the Brigham experience and help fulfill my role in our mission of providing seamless...
Registered Nurse (RN) - Manager, PACU - Post Anesthesia Care - $35 per hour
At Mass General Brigham, we believe in equal access to quality care, employment and advancement opportunities encompassing the full spectrum of human diversity: race, gender, sexual orientation, ability, religion, ethnicity, national origin and all the other forms of human presence and expression th...
Registered Nurse (RN) - STICU - Surgical Trauma Intensive Care - $35 per hour
Brigham and Women’s Hospital I CARE Standards The I CARE Standards guide me in my interactions with patients, family members, visitors, colleagues, and neighbors in my workplace and surrounding community to optimize the Brigham experience and help fulfill my role in our mission of providing seamless...
Immediate Hire For Registered Nurse / Rn Shift Care
We have a new assignment for RN - Med/Surg in Jamaica Plain, MA and are interviewing ASAP. ...
RN - Registered Nurse - Home Care 30+ Hours per Week
Conducting orientation for each new caregiver before the caregiver begins personal care; and providing ongoing training health, aging and other related topics. Conduct regular in-person visits with client and caregiver in a qualified setting to ensure clients remain safe and healthy in the community...
FT Registered Nurse (RN) - Home Health
Our market opportunity is large and growing as the baby boomers age and the home increasingly becomes the epicenter for care as consumers demand convenience and lower-cost solutions. The RN is responsible for administering the Care Plan and the patient/client’s health and wellness as indicated...
Registered Nurse (RN) - PCU - Progressive Care Unit - $35 per hour
Excellent Care to Patients and Families • The Best Staff • In the Safest Environment Schedule: 36hr Variable Rotation One of the fastest growing service lines at BWH, there has never been a more exciting time to join the General Medicine team at BWH! As a 60-bed BWH Intermediate Care (Step-Down) Med...
Acute Registered Nurse - RN
Performs ongoing, systematic collection and analysis of patient data pre – during – post treatment for assigned patients and documents in the patient medical record, makes adjustments and modifications to treatment plan as indicated and notifies Supervisor, Physician, patient’s primary nurse and oth...