RN Integrated Care Manager: Community Health & Coordination

CareSource

Springfield (MA)

On-site

USD 80,000 - 120,000

Full time

4 days ago

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Job summary

CareSource is seeking an Integrated Care Clinical Manager in Massachusetts to provide monitoring, follow-up, and clinical care management for dually-eligible enrollees with complex medical, behavioral, and social needs. You will collaborate with providers and community resources to coordinate enrollee care and improve health outcomes.

The role requires an MA RN license, care coordination experience, and ability to travel to member homes and community settings.

Qualifications

RN license in MA required; dual-eligible population care experience preferred.
AS in Nursing from an accredited program required.
Case management/care coordination experience preferred; Medicaid/Medicare knowledge beneficial.

Responsibilities

Engage enrollees in home and community settings to build a complex care management relationship.
Coordinate with healthcare providers and community resources for seamless care transitions.
Perform comprehensive assessments (e.g., MDS-HC) and functional assessments as needed.
Lead ICT to develop and implement holistic care plans addressing medical and non-medical needs.
Monitor enrollee utilization of long-term services to keep them in their chosen location.
Educate enrollees on benefits, chronic conditions, preventive care, and self-management.
Travel to member/provider/community visits as required; up to 50% travel.
Adhere to NCQA and Care Management standards.