Mobile RN Case Manager: Integrated Care for Dual-Eligible

CareSource; Massachusetts; Sur place; USD 75 000 - 121 000; Plein temps

Résumé du poste

CareSource/Commonwealth Care alliance in Massachusetts seeks an Integrated Care Clinical Manager to oversee complex, dual‑eligible enrollee care. The RN will coordinate clinical care management, perform assessments, and collaborate with the ICT to develop holistic plans that address medical and social needs.

The role emphasizes home/community engagement, care transitions, and facilitating access to resources while ensuring adherence to NCQA and Care Management standards.

Qualifications

• Associates of Science (A.S) degree in nursing from an accredited nursing program required
• A Registered Nurse with the ability to independently serve people with complex medical, behavioral, and social needs. required
• 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

Responsabilités

• Engage enrollee in homes and community settings to build complex care management relationships
• Coordinate with healthcare providers and community resources to ensure seamless care transitions
• Perform assessments including Comprehensive Assessment and MDS-HC functional assessments
• Engage enrollees in care plan development and implementation with regular updates
• Lead the interdisciplinary care team to create holistic care plans addressing medical and non‑medical needs
• Oversee enrollee utilization of long‑term services and supports to keep them in their chosen location
• Coordinate with community organizations and state agencies to avoid service duplication

Connaissances

Interpersonal skills

Communication skills

Microsoft Office

Medicare/Medicaid knowledge

Case management

Critical thinking

Travel readiness

Formation

AS in Nursing

RN license

Case Management Certification preferred

Outils

Microsoft Office

Excel

Outlook

Description du poste

CareSource/Commonwealth Care alliance in Massachusetts seeks an Integrated Care Clinical Manager to oversee complex, dual‑eligible enrollee care. The RN will coordinate clinical care management, perform assessments, and collaborate with the ICT to develop holistic plans that address medical and social needs.

The role emphasizes home/community engagement, care transitions, and facilitating access to resources while ensuring adherence to NCQA and Care Management standards.