Hybrid RN — Complex Care & Care Coordination

WellSense Health Plan; United States; Hybrid; USD 74,000 - 107,000; Full time

Benefits offered by this job

Competitive salary

Excellent benefits

Hybrid work arrangement

Job summary

WellSense Health Plan is seeking a Complex Care Manager to provide holistic care management for members with chronic and complex needs. The role includes conducting assessments, developing ICPs, coordinating care with a multidisciplinary team, and supporting members through home and community-based settings.

This full‑time hybrid position requires an RN license in Massachusetts and about 3 years of relevant experience, with travel up to 50% across Hampden or Worcester Counties.

Qualifications

• Bachelor’s degree in nursing or ADN with relevant work experience.
• Current RN license in Massachusetts.
• 3 years related experience in home health care or managed care.
• Experience with care management, care coordination or discharge planning.

Responsibilities

• Supports programs and clinical best practices to improve health outcomes and reduce readmissions.
• Completes targeted assessments and evaluates needs for complex or chronic conditions.
• Develops an Individual Care Plan with goals and strategies.
• Coordinates care transitions and facilitates access to benefits and resources.
• Conducts face‑to‑face visits and telephonic outreach with members and providers.
• Maintains HIPAA standards and documents in real time.

Skills

Motivational Interviewing

Care coordination

Communication

Collaboration

Education

Bachelor's degree in nursing

Associate's degree in Nursing

Tools

EMR systems

Care management software

Job description

WellSense Health Plan is seeking a Complex Care Manager to provide holistic care management for members with chronic and complex needs. The role includes conducting assessments, developing ICPs, coordinating care with a multidisciplinary team, and supporting members through home and community-based settings.

This full‑time hybrid position requires an RN license in Massachusetts and about 3 years of relevant experience, with travel up to 50% across Hampden or Worcester Counties.