Registered Nurse, RN

Jobtailor; Brockton (MA); On-site; USD 70,000 - 90,000; Full time

Job summary

Jobtailor seeks a dedicated Registered Nurse to provide care management for dually eligible enrollees with complex needs in Massachusetts. You will coordinate care across clinicians and community resources, and engage patients in home and community settings to build strong care relationships.

Strong communication and clinical assessment skills are essential. Responsibilities include leading interdisciplinary teams, developing care plans, and ensuring smooth care transitions while adhering to

Qualifications

• Associate degree in nursing required.
• Active Registered Nurse license in MA required.
• Experience with dual-eligible populations preferred.
• Strong written and verbal communication skills.

Responsibilities

• Provide monitoring, follow-up, and clinical care management to dually eligible enrollees with complex medical, behavioral, and social needs.
• Coordinate enrollee care and integrate health services with community resources.
• Engage enrollees in their homes and communities to build complex care relationships.
• Liaise with providers, resources, and enrollees to ensure care transitions.
• Develop and implement care plans with enrollees; update status accordingly.
• Lead interdisciplinary care teams to create holistic care plans.

Skills

RN

Care Coordination

Case Management

Interdisciplinary Team Leadership

Advocacy

Communication Skills

Microsoft Office

Education

AS in Nursing

RN License

Tools

Microsoft Office

Outlook

Word

Excel

Job description

• Provide monitoring, follow-up, and clinical care management to dually eligible enrollees with complex medical, behavioral, and social care needs
• Integrate health services and community resources to coordinate enrollee care and improve health outcomes and quality of life
• Engage enrollees in their homes and community settings to establish complex care management relationships
• Liaise between healthcare providers, community resources, and enrollees to ensure communication and care transitions
• Complete comprehensive, functional, crisis, and risk assessments
• Develop and implement care plans with enrollees and provide updates as their status changes
• Lead interdisciplinary care teams and create holistic medical and non-medical care plans
• Oversee utilization of long-term services and supports
• Help members access housing, transportation, food assistance, and social services
• Educate members and families about Medicare, Medicaid, chronic conditions, medication adherence, preventive care, healthy lifestyles, and self-management
• Support preventive health strategies and gap closure
• Follow up after hospitalizations or significant health events to promote continuity of care and prevent readmissions
• Coordinate with physicians, specialists, community organizations, state agencies, and service providers
• Advocate for enrollee needs and preferences and evaluate member satisfaction
• Conduct regular member, provider, and community-based visits
• Report abuse, neglect, or exploitation as a mandated reporter under state law
• Adhere to NCQA and Care Management standards
• Perform other related duties as requested

Requirements

• Associate of Science (A.S.) degree in nursing from an accredited nursing program required
• Registered Nurse able to independently serve people with complex medical, behavioral, and social needs
• Current unrestricted clinical license in the Commonwealth of Massachusetts as a Registered Nurse (RN) required
• Intermediate proficiency with Microsoft Office, including Outlook, Word, and Excel
• Understanding of Medicare and Medicaid programs and community resources for dual-eligible beneficiaries
• Strong written and verbal communication, interpersonal, customer relations, and customer service skills
• Ability to manage multiple cases and priorities with attention to detail
• Adherence to a professional code of ethics
• Awareness and sensitivity to diverse backgrounds and population needs
• Decision-making and problem-solving skills
• Ability to work independently and effectively as part of an interdisciplinary team
• Valid driver's license, vehicle, and verifiable insurance required
• Successful driver's license record check required
• Annual influenza vaccination required during influenza season
• Must reside in the assigned territory and within commutable distance to the Commonwealth of Massachusetts
• May be required to travel greater than 50% of the time
• Prior care coordination, case management, or dual-eligible population experience preferred
• Medicaid and/or Medicare managed care experience preferred
• Clinical field/community-based training is a plus
• Case Management Certification highly preferred

Core Competencies

Demonstrates expertise in care management for dually eligible enrollees, integrating health services and community resources to enhance health outcomes. Proficient in conducting assessments, developing care plans, and leading interdisciplinary teams while adhering to regulatory standards.

Highest-signal resume keywords

• Registered Nurse (RN)
• Care Coordination
• Medicare and Medicaid Knowledge
• Case Management Certification
• Interdisciplinary Team Leadership

Hard Skills

• Clinical Assessments
• Care Plan Development
• Crisis Management
• Utilization Management
• Preventive Health Strategies
• Community Resource Coordination
• Health Education
• Risk Assessment
• Behavioral Health Management
• Complex Care Management

Soft Skills

• Strong Communication Skills
• Interpersonal Skills
• Customer Service Skills
• Decision-Making Skills
• Problem-Solving Skills

Certifications & Qualifications

• Registered Nurse License
• Case Management Certification

Industry Keywords

• Dually Eligible Beneficiaries
• NCQA Standards
• Long-Term Services and Supports
• Community-Based Care
• Healthcare Provider Liaison

Tools & Technologies

• Microsoft Office
• Outlook
• Word
• Excel