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  3. RN Case Manager
Blue Cross Blue Shield of Massachusetts logo

RN Case Manager

Blue Cross Blue Shield of Massachusetts·Hingham, Massachusetts

$44 - $54/hrFull TimeRemote OkRemote friendly2-5 yrsPosted 5 days ago

RN Case Manager · $44 - $54/hr

Practice for this role

How this role compares

Computed from live listings

  • +19% vs. median posted rate for nursing roles in Hingham, Massachusetts ($37.00/hr)
  • 14 similar openings in the Hingham area · median $37.00/hr
$19.50/hr · lowesthighest · $57.00/hr
this role: $44.12/hrmedian $37.00/hr

Shaded band: the middle 50% of posted nursing roles in Hingham, Massachusetts rates. This role sits in the 81st percentile.

About the role

Pay for this role is about 19% above the Hingham, Massachusetts median for nursing roles.

The Clinical Care Manager facilitates care for members with complex health needs by assessing requirements and identifying barriers to care. They collaborate with a multidisciplinary team to develop, document, and monitor comprehensive care management plans while ensuring compliance with regulatory standards.

Ready for your next chapter at Blue? Grow your career and deepen your impact The Role The Role The Clinical Care Manager is responsible for facilitating care for members and families of members who may have rising health risks or complex healthcare needs, to promote optimal health. This position is self-directed and works independently and collaboratively to facilitate care based on the principles of care management. Facilitation is focused on assessing needs, identifying health care disparities, social determinants of health, and any barriers to care. The Team The Team The Clinical Care Manager is part of a highly dedicated and motivated team of professionals, including medical and behavioral health care managers, dieticians, pharmacist, clinicians, medical directors and more, who collaborate to facilitate care. Key Responsibilities:

Engage members in appropriate plans of care, coordinate care and services as appropriate, communicate effectively and provide members with education and resources as needed.Promote member compliance with treatment plan, encourage shared decision-making, and set appropriate goals to promote optimal member outcomes.

Interpret and apply case management criteria, processes, policies, and regulatory standards to create, follow and appropriately document comprehensive care management plans.

Review medication list and educate members with complex pharmacy needs, and counsel on side effects and mitigation strategies for specific treatment protocols.

Successfully connect, engage, and maintain member engagement to support seamless care transitions and optimized health outcomes.

Interact with treatment providers, PCPs, physicians, therapists, and facilities as needed to gather clinical information to support the plan of care.

Monitor clinical quality concerns, make referrals appropriately, identify and escalate quality of care issues.

Understand member insurance products and benefits, as well as regulatory and NCQA requirements. Key Qualifications:

Ability to identify and document member-driven, specific, measurable activities that address actionable behaviors and goals

Self-directed, independent, adaptive, flexible to change, and able to collaborate as a member of a team.

Proficient with multiple IT systems.

Demonstration of awareness, attitude, knowledge, and skills needed to work effectively with a culturally and demographically diverse population. Education and Experience:

3-5 years relevant experience in a variety of appropriate clinical health care settings (Inpatient, outpatient, or differing levels of care).

Requirements

Candidates must have 3-5 years of relevant clinical experience and an active Massachusetts RN or PT license. Proficiency in IT systems and the ability to work effectively with diverse populations are essential qualifications.

  • Documentation
  • Care coordination
  • Patient education
  • Regulatory compliance
  • Interdisciplinary collaboration
  • Case management
  • Utilization management
  • Cultural competence
  • Health assessment
  • Medication review
  • NCQA standards
  • Clinical care management
  • IT systems proficiency

Benefits

  • 401(k)
  • Dental insurance
  • Vision insurance
  • Medical insurance
  • Paid time off
  • Well-being benefits

Posting details

Employment type
Full Time
Work arrangement
Remote Ok
Experience
2-5 yrs
Salary
$44 - $54/hr
Location
Hingham, Massachusetts
Posted
Sep 8, 2026
Application
Employer website
Blue Cross Blue Shield of Massachusetts logo

Hiring organization

Blue Cross Blue Shield of Massachusetts

Blue Cross Blue Shield of Massachusetts is a community-focused, tax-paying, not-for-profit health plan headquartered in Boston. We have been a market leader for over 80 years, and are consistently ranked among the nation's best health plans. Our daily efforts are dedicated to...

IndustryHospitals and Health Care
TypeNonprofit
Size1,001-5,000 employees
View profile

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Utilization Management experience, preferred

Active licensure in Massachusetts is required, appropriate to position (RN/PT) o Licensure in additional states a plus. o Note: Any restrictions against a license must be disclosed and reviewed. #LI-REMOTE Blue Cross Blue Shield of Massachusetts is an Equal Employment Employer - veterans/disability. 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. Blue Cross Blue Shield of Massachusetts will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with Blue Cross Blue Shield of Massachusetts's legal duty to furnish information. Location Hingham Time Type Full time Weekly Hours 37.5 Grade of Position Hourly Range: $44.12 - $53.93 Number of Openings Available 4

The job posting range is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting.

We may ultimately pay more or less than the posted range, and the range may be modified in the future.

An employee’s pay position within the salary range will be based on several factors including, but limited to, relevant education, qualifications, certifications, experience, skills, performance, shift, travel requirements, sales or revenue-based metrics, and business or organizational needs and affordability.

This job is also eligible for variable pay.

We offer comprehensive package of benefits including paid time off, medical/dental/vision insurance, 401(k), and a suite of well-being benefits to eligible employees.

Note

No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law. WHY Blue Cross Blue Shield of MA? We understand that the confidence gap and imposter syndrome can prevent amazing candidates coming our way, so please don’t hesitate to apply. We’d love to hear from you. You might be just what we need for this role or possibly another one at Blue Cross Blue Shield of MA. The more voices we have represented and amplified in our business, the more we will all thrive, contribute, and be brilliant. We encourage you to bring us your true colors, , your perspectives, and your experiences. It’s in our differences that we will remain relentless in our pursuit to transform healthcare for ALL. As an employer, we are committed to investing in your development and providing the necessary resources to enable your success. Learn how we are dedicated to creating an inclusive and rewarding workplace that promotes excellence and provides opportunities for employees to forge their unique career path by visiting our Company Culture page. If this sounds like something you’d like to be a part of, we’d love to hear from you. You can also join our Talent Community to stay “in the know” on all things Blue. At Blue Cross Blue Shield of Massachusetts, we believe in wellness and that work/life balance is a key part of associate wellbeing. For more information on how we work and support that work/life balance visit our "How We Work" Page.

Market context

RN case management demand in Massachusetts

RN case manager roles in Massachusetts are often competitive because employers look for nurses who can combine acute-care judgment with care coordination, documentation, and patient follow-up. This posting’s requirements suggest a typical demand for licensed RNs with med-surg or acute care experience, CPR certification, EMR proficiency, and reliable transportation for field or community-based work. Review the AI-summarized requirements and benefits here to save time, then confirm your license status and recent care-management examples before applying.

More openings at Blue Cross Blue Shield of Massachusetts

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Blue Cross Blue Shield of Massachusetts logo

Blue Cross Blue Shield of Massachusetts

Utilization Management Reviewer - Behavioral Health

Hingham, Massachusetts

$39 - $47/hr

12 days ago