In-Home RN Care Manager – Dual-Eligible Support

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

Job summary

CareSource/Commonwealth Care Alliance (CCA) seeks an Integrated Care Clinical Manager in Massachusetts. The role focuses on providing monitoring, follow-up, and care management for dually-eligible enrollees with complex medical, behavioral, and social needs, in home and community settings.

You will lead an interdisciplinary team, coordinate with providers and community resources, and promote comprehensive, person-centered care across Medicare and Medicaid services.

Qualifications

• Associates of Science (A.S) degree in nursing required.
• Massachusetts RN license required to independently serve people with complex medical, behavioral, and social needs.
• Case management or care coordination experience preferred.
• Medicare/Medicaid knowledge preferred.

Responsibilities

• Engage enrollees in home and community settings to establish a complex care management relationship.
• Coordinate with healthcare providers and community resources to ensure seamless care transitions.
• Conduct comprehensive assessments and functional assessments as needed.
• Lead an interdisciplinary care team to create holistic care plans addressing medical and non-medical needs.
• Monitor enrollee utilization of long-term services to keep them in their chosen location.
• Educate members about benefits, services, and chronic condition management.
• Ensure follow-up after hospitalizations to prevent readmissions.

Skills

Interpersonal communication

Customer service

Multitasking

Decision making

Education

Associate of Science in Nursing

Massachusetts RN license

Case Management Certification

Tools

Microsoft Office

Outlook

Excel

Job description

CareSource/Commonwealth Care Alliance (CCA) seeks an Integrated Care Clinical Manager in Massachusetts. The role focuses on providing monitoring, follow-up, and care management for dually-eligible enrollees with complex medical, behavioral, and social needs, in home and community settings.

You will lead an interdisciplinary team, coordinate with providers and community resources, and promote comprehensive, person-centered care across Medicare and Medicaid services.