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Clinical Nurses (Care Management) New

Quincy, MA

Details

Hiring Company

Blue Cross Blue Shield of MA

Positions Available

Full Time, Part Time

No recruiters please


Position Description

Clinical Nurses (Care Management)

Blue Cross Blue Shield of MA 

Quincy, MA 02171 

If you're looking for a challenging work environment, opportunities to continually develop your skills, and be part of an organization that is dedicated to being an outstanding citizen and community leader, you've found the right place—because it happens here.

Career Event for Clinical Nurses                     
Tuesday, August 15
3:30PM-7:00PM
Blue Cross Blue Shield of MA
1 Enterprise Drive
Quincy MA 02171
Register Today!

We are currently seeking qualified individuals to join our Care Management Team in the following positions:

Care Manager

  • 5-10 years’ direct clinical experience
  • Health care professional with active Massachusetts license
  • Bachelor’s degree preferred in nursing or other allied health field; Master’s degree a plus
  • Certified Case Manager (CCM) is required
  • Certified Wellness Coaching is preferred

Case Manager

  • 3-5 years’ direct clinical experience
  • Health care professional with active Massachusetts license; Licensure in additional states a plus
  • Bachelor’s degree preferred in nursing or other allied health field; Master’s degree a plus
  • Certified Case Manager (CCM) is preferred
  • Certified Wellness Coaching is preferred
  • Ability to demonstrate proficiency with information technology systems

Clinical Reviewer

  • 3 years’ direct clinical experience preferred
  • Health care professional with active Massachusetts license
  • Bachelor’s degree preferred in nursing or other allied health field; Master’s degree a plus
  • Managed care experience preferred
  • Bilingual a plus
  • Ability to work in a highly computerized environment

Quality Consultant

  • RN or clinical professional degree with active Massachusetts license (clinical)
  • 5+ years in a clinical managed care environment
  • 3-5 years’ experience working with relevant NCQA Standards, CMS compliance or other quality improvement/compliance management, or demonstrate competencies of the position and has successfully prepared for and completed essential components of the role, such as third party audits
  • Master’s degree preferred

OR:

  • Bachelor’s degree required; Advanced degree preferred (i.e. business or health administration) or applicable certification (Quality, Compliance, Project Management)
  • 3+ years’ experience in managed care, quality improvement, or compliance experience required
  • 3-5 years’ experience working with relevant NCQA Standards, CMS compliance or other quality improvement/compliance management, or demonstrates competencies of the position and has successfully prepared for and completed essential components of the role, such as third party audits 3-5 years’ direct clinical experience

Voted as one of the Most Admired Health Care Companies by Boston Business Journal, Blue Cross Blue Shield of Massachusetts is a community-focused, not-for-profit health plan. A market leader for over 75 years, we are consistently ranked among the nation's best health plans.

Register Today!

If you are unable to attend our event, please apply online at:
www.bluecrossma.com/visitor/it-happens-here/

Blue Cross Blue Shield of Massachusetts is an Equal Employment/Affirmative Action Employer. 
Applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or expression, or any other characteristics protected by law.

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