RN Care Navigator: Community-Based Dual-Eligible Care

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

Job summary

CareSource in Massachusetts seeks an Integrated Care Clinical Manager (RN) to oversee complex care management for dually-eligible enrollees. The role focuses on integrating health services with community resources to improve outcomes and quality of life.

The position requires an MA-licensed RN, experience in care coordination, and willingness to travel within the state; a Case Management Certification is preferred. Competitive salary and benefits provided.

Qualifications

• AS degree in nursing from an accredited program.
• Registered Nurse with the ability to independently serve individuals with complex medical, behavioural and social needs.
• Prior experience in care coordination, case management or working with dual-eligible populations is preferred.
• Medicaid and/or Medicare managed-care experience is preferred.

Responsibilities

• Engage enrollees in homes and community settings to build a complex care management relationship, considering cultural and linguistic needs.
• Function as liaison between healthcare providers, community resources and enrollees for seamless communication and care transitions.
• Perform assessments including Comprehensive Assessment and MDS-HC (or successor) Functional Assessments and Crisis/Risk Assessments.
• Lead the interdisciplinary care team (ICT) to create holistic care plans addressing medical and non-medical needs.
• Oversee enrollee utilisation of long-term supports to ensure appropriate systems for staying in preferred location.
• Travel regularly to conduct member, provider and community visits.

Skills

Interpersonal skills

Communication skills

Healthcare coordination

Education

Associate of Science in Nursing

Registered Nurse (RN) in MA

Case Management Certification (preferred)

Driver's license and vehicle

Tools

Microsoft Office

Job description

CareSource in Massachusetts seeks an Integrated Care Clinical Manager (RN) to oversee complex care management for dually-eligible enrollees. The role focuses on integrating health services with community resources to improve outcomes and quality of life.

The position requires an MA-licensed RN, experience in care coordination, and willingness to travel within the state; a Case Management Certification is preferred. Competitive salary and benefits provided.