Direct Clinical Care Manager

Blue Cross Blue Shield of Massachusetts

. Facilitate and deliver care to members to increase access to care and improve clinical outcomes .

Posted 10/2/2026full-timeBoston • Massachusetts • United StatesMid-LevelSenior💰 $115,200 - $140,800 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in care delivery, chronic disease management, and telehealth services, with a strong focus on patient engagement and compliance. Proficient in applying case management processes and collaborating with diverse healthcare teams to enhance clinical outcomes.

Highest-signal resume keywords

Licensed Nurse Practitioner (NP) in MassachusettsChronic Disease ManagementTelehealth ServicesPatient EngagementCase Management Processes

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Chronic Disease ManagementTelehealth ServicesCare CoordinationClinical Protocol DevelopmentElectronic Medical Record WorkflowsMedication ReviewPatient EducationQuality MonitoringRegulatory Standards ComplianceDocumentation of Care Management Plans

Soft Skills

Effective CommunicationTeam CollaborationAdaptabilityRelationship ManagementCultural Competence

Tools & Technologies

IT Systems ProficiencyElectronic Medical Records

Certifications & Qualifications

Licensed Nurse Practitioner (NP)

Industry Keywords

BCBSMA Products and BenefitsMedicareNCQA RequirementsAmbulatory CarePatient-Centered Care

About the role

Key responsibilities & impact

Facilitate and deliver care to members to increase access to care and improve clinical outcomes
Conduct telehealth visits by video and phone with BCBSMA members
Manage chronic diseases for Medicare-age members, specifically hypertension and diabetes, through remote workflows
Co-design an innovative virtual care program, including workflows and clinical protocols, with Medical Director support
Use electronic medical record workflows and documentation effectively
Engage members in plans of care, coordinate care and services, communicate effectively, and provide education and resources
Promote treatment-plan compliance, shared decision-making, and goals for optimal outcomes
Apply case management criteria, processes, policies, and regulatory standards to create and document comprehensive care management plans
Review medication lists, educate members with complex pharmacy needs, and counsel on side effects and mitigation strategies
Connect, engage, and maintain member engagement to support care transitions and health outcomes
Collaborate with treatment providers, PCPs, physicians, therapists, and facilities to gather clinical information
Monitor clinical quality concerns, make referrals, and identify and escalate quality-of-care issues
Understand BCBSMA products and benefits and regulatory and NCQA requirements
Work collaboratively with medical and behavioral health care managers, dieticians, pharmacists, clinicians, and medical directors

Requirements

What you’ll need

Currently licensed as an NP in Massachusetts
3–5 years recent experience in care delivery
Willingness to continue clinical practice
Ideally 10+ years’ experience in ambulatory care, preferably as a primary care provider
Proven abilities in patient engagement and relationship management
Ability to identify and document member-driven, specific, measurable activities addressing actionable behaviors and goals
Self-directed, independent, adaptive, and flexible to change
Ability to collaborate as a member of a team
Proficient with multiple IT systems
Awareness, attitude, knowledge, and skills to work effectively with a culturally and demographically diverse population
High school degree or equivalent required unless otherwise noted above

Benefits

Comp & perks

Variable pay eligibility
Paid time off
Medical insurance
Dental insurance
Vision insurance
401(k)
Suite of well-being benefits
Employee development investment and resources
Inclusive and rewarding workplace
Opportunities to forge a unique career path
Work/life balance support