Neponset Health Center is seeking a Nurse High Risk Care Manager (Dorchester, MA)
The Nurse High Risk Care Manager manages the Blue Cross Alternative Quality Care Contract (AQC) patient panels to ensure quality measures are met. The Nurse Care Manager performs a variety of diverse and complex telephonic and face to face care management techniques, works closely with behavioral health staff to co-manage complex members, leads primary care team in creation of individualized care plans, follows patient through continuum including acting as liaison for network staff, hospital staff, PCP and other healthcare team members, and performs case management services taking into consideration the patients physical, cultural, social and psychological needs.
Minimum Skills, Experience and Educational Requirements:
Bachelor's Degree in Nursing,
3 years of experience in medical case management in acute care, ambulatory care or health insurance environment,
strong analytical and clinical problem solving skills,
Microsoft Office experience including Outlook, Word and Excel,
Strong oral and written communication skills, experience in using clinical data and developing interventions.
Required Certifications and Licenses:
Current MA License as a Registered Nurse
Preferred Skills, Experience and Educational Requirement:
Experience with Blue Cross Alternative Quality Care Contract,
Clinical Care Management (CCM) Certification,
Bilingual, demonstrates knowledge of providing culturally appropriate care, 3 years related experience in ambulatory care environment,
NextGen EPM experience,
Working knowledge of NCQA patient centered medical standards,
Knowledge of GE Lean principles.
Please APPLY ONLINE AT HTTP://CAREERS.HHSI.US/CAREERS/
For more information, call 617-533-2300 or visit our website at www.hhsi.us >> Read More