Hybrid Registered Nurse, Clinical Care Manager

at CareSource

• Job title: Registered Nurse, Clinical Care Manager
• Job type: Full Time
• Experience level: Mid level, Senior
• Salary: $90,000 - $120,000 per year
• Degree requirement: Associate's Degree
• Location requirements: Hybrid, Boston, United States

About the role

• Clinical Care Manager responsible for coordinating care for dually-eligible enrollees in MA. Engaging community resources and healthcare providers to improve health outcomes.

Responsibilities

• The Clinical Care Manager is responsible for providing monitoring, follow-up and clinical care management to dually-eligible enrollees with complex medical, behavioral and social care needs.
• Engage with the enrollee in their homes and other community settings to establish a complex care management relationship.
• Function as a liaison between healthcare providers, community resources, and enrollees.
• Perform required assessments on a timely basis, including Comprehensive Assessment, MDS-HC (or successor) Functional Assessments, and Crisis and Risk Assessments.
• Lead the interdisciplinary care team (ICT) to create holistic care plans.
• Oversee enrollee utilization of long-term services and supports.
• Assist members in accessing community resources like housing, food assistance, etc.
• Provide education to members and families about managing chronic conditions and preventive care.
• Follow up with members after hospitalizations to ensure continuity of care.
• 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.
• Influenza vaccination is a requirement of this position.

Benefits

• Health insurance
• Retirement plans
• Flexible work arrangements
• Professional development opportunities
• Significant bonuses tied to individual and company performance
• Employee well-being programs