Home-Based RN Care Manager for Dual-Eligible Patients

CareSource; Springfield, Northern (MA, KY); Hybrid; USD 80,000 - 120,000; Full time

Job summary

CareSource/Commonwealth Care Alliance seeks an Integrated Care Clinical Manager (RN) in Massachusetts to monitor, coordinate, and manage care for dually-eligible enrollees with complex needs in home and community settings.

The role leads the interdisciplinary team, conducts comprehensive assessments, and promotes preventive care while educating members about Medicare/Medicaid benefits. Travel within the territory is required to ensure seamless care transitions and high-quality outcomes.

Qualifications

• ASN degree in nursing is required.
• Current unrestricted RN license required.
• Medicaid/Medicare managed care experience preferred.
• Case Management certification is highly preferred.

Responsibilities

• Engage enrollees in homes and community settings to establish complex care management relationships.
• Function as liaison between providers, resources, and enrollees for seamless communication and care transitions.
• Conduct comprehensive assessments including MDS-HC and risk assessments.
• Lead the interdisciplinary care team to create holistic care plans addressing medical and non-medical needs.
• Coordinate enrollee utilization of long-term supports to enable staying in the preferred location.
• Educate members and families about benefits and preventive care under Medicare and Medicaid.
• Follow up after hospitalizations to ensure continuity of care and prevent readmissions.

Skills

MS Office

Medicare/Medicaid

Interdisciplinary teamwork

Communication skills

Care coordination

Dual-eligible care

Education

ASN degree

RN license

Medicaid/Medicare managed care experience (preferred)

Job description

CareSource/Commonwealth Care Alliance seeks an Integrated Care Clinical Manager (RN) in Massachusetts to monitor, coordinate, and manage care for dually-eligible enrollees with complex needs in home and community settings.

The role leads the interdisciplinary team, conducts comprehensive assessments, and promotes preventive care while educating members about Medicare/Medicaid benefits. Travel within the territory is required to ensure seamless care transitions and high-quality outcomes.