Hybrid RN Case Manager — Sign-On Bonus

Commonwealth Care Alliance Inc; Medford (MA); Hybrid; USD 80,000 - 120,000; Full time

Benefits offered by this job

Sign-on bonus

Hybrid work model

Job summary

Commonwealth Care Alliance is seeking a Hybrid Registered Nurse (RN) Case Manager in Massachusetts to provide integrated care management for dually-eligible enrollees with complex needs. The role focuses on coordinating medical, behavioral and social services to improve health outcomes and quality of life.

The RN will conduct in-home assessments, develop care plans, lead the interdisciplinary team, and ensure smooth care transitions across providers.

Qualifications

• AS degree from an accredited nursing program required.
• Registered Nurse with the ability to independently serve people with complex medical, behavioral, and social needs.
• Prior experience in care coordination, case management, or working with dual-eligible populations preferred.
• Medicaid and/or Medicare managed care experience preferred.
• Clinical Field/Community Based Training a Plus

Responsibilities

• Engage with enrollees in their homes and community settings to establish a complex care management relationship.
• Liaise between healthcare providers, community resources, and enrollees to ensure seamless communication and transitions.
• Perform Comprehensive Assessments and Functional Assessments as required.
• Develop and implement care plans, updating as enrollee status changes.
• Lead the interdisciplinary care team to address medical and non-medical needs.
• Oversee enrollment in long-term services and supports to support choice of location.
• Educate members about benefits and services under Medicare and Medicaid.
• Promote healthy lifestyle choices and preventive care.
• Follow up after hospitalizations to ensure continuity of care and prevent readmissions.
• Coordinate with primary care physicians and other providers to share information.
• Advocate for enrollees within the healthcare system.
• Regularly evaluate member satisfaction and address concerns.
• Travel to member, provider, and community visits as required.
• Adhere to NCQA and Care Management standards and report any issues.

Skills

RN license

Care coordination

Travel for visits

Interpersonal skills

Communication skills

Microsoft Office

Education

Associate of Science in Nursing

Job description

Commonwealth Care Alliance is seeking a Hybrid Registered Nurse (RN) Case Manager in Massachusetts to provide integrated care management for dually-eligible enrollees with complex needs. The role focuses on coordinating medical, behavioral and social services to improve health outcomes and quality of life.

The RN will conduct in-home assessments, develop care plans, lead the interdisciplinary team, and ensure smooth care transitions across providers.