Integrated Care Lead Clinician - Home & Community

CareSource; Massachusetts; On-site; USD 80,000 - 120,000; Full time

Job summary

CareSource in Massachusetts seeks an Integrated Care Clinical Manager - BH to deliver monitoring, follow-up, and clinical care management for dually eligible enrollees with complex needs. This mobile role coordinates care across providers and community resources, aiming to improve outcomes and quality of life.

The position emphasizes integration of health services, collaboration with an interdisciplinary team, and ongoing education for members and families on benefits and preventive care.

Qualifications

• Master's degree in social work or mental health counseling and independent license required.
• BH Clinician capable of serving people with complex medical, behavioral, and social needs.
• Experience in care coordination or case management; Medicaid/Medicare managed care preferred.
• Clinical field/community-based training is a plus.

Responsibilities

• Engage enrollees in homes and community settings to establish a complex care management relationship.
• Coordinate between providers, resources, and enrollees for seamless communication and transitions.
• Conduct comprehensive assessments including MDS-HC and risk assessments.
• Lead the interdisciplinary care team to develop holistic care plans addressing medical and social needs.
• Oversee use of long-term services and supports to keep enrollees in their chosen location.
• Assist members with housing, transportation, and social services access.
• Educate members about Medicare and Medicaid benefits and services.
• Promote self-management, preventive care, and gap closure.
• Follow up after hospitalizations to ensure continuity of care and reduce readmissions.
• Travel to member/provider/community visits as required.

Skills

Interpersonal skills

Care coordination

Case management

Communication skills

Cultural sensitivity

Education

Master's degree in social work or mental health counseling

Independent license (LCSW/LISCW/LMHC)

Case Management Certification (preferred)

Tools

Microsoft Office (Outlook, Word, Excel)

Job description

CareSource in Massachusetts seeks an Integrated Care Clinical Manager - BH to deliver monitoring, follow-up, and clinical care management for dually eligible enrollees with complex needs. This mobile role coordinates care across providers and community resources, aiming to improve outcomes and quality of life.

The position emphasizes integration of health services, collaboration with an interdisciplinary team, and ongoing education for members and families on benefits and preventive care.