Regional Care Manager
Neighborhood Health Plan (NHP) - Boston, MA

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Neighborhood Health Plan (NHP), located in Boston, is currently seeking an experienced, highly skilled Care Manager to ensure members with specialized needs receive the care they need.

The Care Manager will assess, plan, implement, and evaluate care plans for members. He/she will collaborate with other NHP clinical teams and outside providers to develop a comprehensive approach to care coordination with emphasis on telephonic review for acute inpatient stays.

This position is telephonic in an office environment.

Primary Responsibilities:
  • Demonstrate creativity in formulating care plans from assessment and clinical information
  • Telephonic review for acute inpatient stays
  • Utilization management
  • Use evaluative and outcomes data to improve ongoing care management services
  • Promote health care outcomes in concert with currently accepted clinical practice guidelines
  • Adhere to the code of ethics for the care manager's professional discipline
  • Develop and maintain collaborative, proactive and patient focused relationships to maximize client health care outcomes
  • Serve as a member advocate
  • Build collaborative working relationships with Health Center / Provider partner staff, including participating in regularly scheduled site visits to promote NHP care management programs
  • Participate in work groups specific to the program
  • Participate in quality improvement initiatives within the clinical operations department
  • Some local travel required

Preferred Qualifications:
  • Valid Unrestricted Massachusetts RN or other Health Care Clinical professional license
  • Bachelor's degree or equivalent work experience
  • 3-5 years acute or program-specific population/disease expertise
  • Recent acute care experience a plus
  • CCM, Managed Care, Home Health Nursing experience preferred
  • Web based research skills
  • Excellent verbal and written communication skills
  • Demonstrated ability to multi-task
  • Works with minimal or direct supervision
  • Competency with Windows based systems, Microsoft Office applications
  • Competence in or ability to learn NHP Care Management software and utilization systems, CCA, or other as required

NHP offers competitive salaries and an excellent flexible benefits package that includes medical, dental and vision insurance, generous earned time, commuter benefit, and a 401(k) employer contributed retirement program.

NHP's mission targets a diverse population and our employees are just as diverse. As an equal opportunity employer, NHP recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives, and backgrounds.


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