RN Care Navigator for Dual-Eligible Health

CareSource; Fall River (MA); On-site; USD 90,000 - 120,000; Full time

Job summary

CareSource is seeking a Clinical Care Manager in Massachusetts to provide home-based care coordination for dually-eligible enrollees with complex medical, behavioral, and social needs. You will work with an ICT to develop holistic care plans and ensure smooth transitions between providers and community services.

Your role includes conducting comprehensive assessments, educating members on benefits, and promoting preventive care while traveling to visits as needed.

Qualifications

• Associates of Science (A.S) degree in nursing required; or Masters in social work or mental health counseling with independent license.
• Three (3) years RN/BH clinician experience; or one (1) year RN/BH with two (2) years working with dual-eligible populations.
• Prior care coordination or case management experience with dual-eligible populations preferred.

Responsibilities

• Engage enrollees in homes and community settings, establishing complex care management relationships.
• Coordinate with healthcare providers and community resources to ensure seamless care transitions.
• Perform Comprehensive Assessments including MDS-HC Functional Assessments.
• Lead interdisciplinary care team to develop holistic care plans.
• Oversee utilization of long-term services to support enrollees in their chosen location.
• Assist members in accessing housing, transportation, food assistance, and social services.
• Educate members about benefits under Medicare and Medicaid and disease management.
• Follow up after hospitalizations to prevent readmissions and ensure continuity of care.
• Travel to member and provider visits as required; ensure coordination and avoid duplications.

Skills

Home visits

Care coordination

Interdisciplinary teamwork

Communication skills

MDS-HC assessments

Chronic disease management

Medicare/Medicaid knowledge

Microsoft Office

Patient education

Cultural competence

Education

ASN in Nursing

MSW or LMHC license

RN/LCSW/LISCW/LMHC license

Case management experience

Tools

Microsoft Office

Job description

CareSource is seeking a Clinical Care Manager in Massachusetts to provide home-based care coordination for dually-eligible enrollees with complex medical, behavioral, and social needs. You will work with an ICT to develop holistic care plans and ensure smooth transitions between providers and community services.

Your role includes conducting comprehensive assessments, educating members on benefits, and promoting preventive care while traveling to visits as needed.