RN Integrated Care Manager - Field-Based Home & Community Care

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

Job summary

CareSource is seeking an Integrated Care Clinical Manager for Massachusetts. This community-based RN will monitor, follow up and manage care for dually-eligible enrollees with complex medical, behavioral and social needs.

The role coordinates health services and community resources, leads the ICT, and ensures smooth transitions while assisting enrollees in accessing housing, transportation and social services. Travel within MA is required.

Qualifications

• AS degree in nursing from an accredited program.
• RN licensed with ability to independently serve individuals with complex medical, behavioral and social needs.
• Medicaid/Medicare managed-care experience is preferred.
• Clinical field or community-based training is a plus.

Responsibilities

• Engage enrollees in homes and community settings to establish a complex care management relationship.
• Function as liaison between providers, community resources and enrollees for seamless communication.
• Perform comprehensive assessments (CGA, MDS-HC or successor) and risk assessments.
• Lead the interdisciplinary care team (ICT) to create holistic care plans.
• Oversee enrollee utilization of long-term services and supports and ensure appropriate systems.
• Assist members in accessing community resources (housing, transportation, food, social services).
• Educate members about benefits and services under Medicare/Medicaid.
• Follow up after hospitalisations to ensure continuity of care and prevent readmissions.
• Coordinate with PCPs, specialists, and other providers; share relevant information.
• Advocate for enrollee needs; report concerns; travel for member/provider visits as required.
• Adhere to NCQA and Care Management standards.

Skills

Interpersonal communication

Case management

Decision-making

Team collaboration

Customer service

Cultural sensitivity

Education

AS in Nursing

RN license

Case Management Certification (preferred)

Tools

Microsoft Office (Outlook, Word, Excel)

Job description

CareSource is seeking an Integrated Care Clinical Manager for Massachusetts. This community-based RN will monitor, follow up and manage care for dually-eligible enrollees with complex medical, behavioral and social needs.

The role coordinates health services and community resources, leads the ICT, and ensures smooth transitions while assisting enrollees in accessing housing, transportation and social services. Travel within MA is required.