Hybrid Behavioral Health Clinical Care Manager, RN, LICSW, LMHC

at CareSource

• Job title: Behavioral Health Clinical Care Manager, RN, LICSW, LMHC
• Job type: Full Time
• Experience level: Mid level, Senior
• Salary: $90,000 - $120,000 per year
• Degree requirement: Associate's Degree
• Location requirements: Hybrid, Taunton, United States

About the role

• Clinical Care Manager delivering community-based health services to dual-eligible enrollees in Massachusetts. Engaging with members to ensure continuity of care and accessing community resources.

Responsibilities

• Engage with the enrollee in their homes and other community settings to establish an effective, complex care management relationship
• Function as a liaison between healthcare providers, community resources, and enrollees to ensure seamless communication and care transitions
• Perform required assessments on a timely basis, including but not limited to Comprehensive Assessment, MDS-HC (or successor) Functional Assessments, and Crisis and Risk Assessments
• Engage enrollees in care plan development and implementation
• Lead the interdisciplinary care team (ICT) and collaborate with peers both internal and external to the organization
• Oversee enrollee utilization of long-term services and supports
• Assist members in accessing community resources, including housing, transportation, food assistance, and social services.
• Educate members about their benefits and available services under both Medicare and Medicaid.
• Follow up with members after hospitalizations or significant health events to ensure continuity of care and prevent readmissions.
• Coordinate with community-based organizations, other stakeholders/entities, state agencies, and other service providers to ensure coordination and avoid duplication of services
• Advocate for the needs and preferences of enrollees within the healthcare system.

Requirements

• Associates of Science (A.S) degree in nursing from an accredited nursing program required or Master's degree in social work or mental health counseling and independent license required
• Three (3) years of experience as a Registered Nurse/BH Clinician or One (1) year as a Registered Nurse/BH Clinician with two (2) years of experience working with people with complex medical, behavioral and social needs as an LPN, CHW, MA required
• Prior experience in care coordination, case management, or working with dual-eligible populations preferred
• Medicaid and/or Medicare managed care experience preferred
• Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel.
• Understanding of Medicare and Medicaid programs, as well community resources and services available to dual-eligible beneficiaries.
• Must have valid driver's license, vehicle and verifiable insurance.

Benefits

• Health insurance
• Retirement plans
• Paid time off
• Flexible work arrangements
• Professional development