Clinical Care Manager, LICSW/LMHC

. Provide monitoring, follow-up, and clinical care management to dual-eligible enrollees with complex medical, behavioral, and social needs .

Posted 9/25/2026full-timePlymouth • Massachusetts • United StatesMid-LevelSenior💰 $80,000 - $120,000 per yearWebsite

Key responsibilities & impact

Provide monitoring, follow-up, and clinical care management to dual-eligible enrollees with complex medical, behavioral, and social needs
Engage enrollees in their homes and community settings
Establish complex care management relationships while considering cultural and linguistic needs
Liaise among healthcare providers, community resources, and enrollees
Perform comprehensive, functional, crisis, and risk assessments
Develop and update care plans with enrollees
Lead interdisciplinary care teams and collaborate with internal and external peers
Oversee utilization of long-term services and supports
Assist members with housing, transportation, food assistance, and social services
Educate members about Medicare and Medicaid benefits and available services
Educate members and families about chronic conditions, medication adherence, and preventive care
Promote healthy lifestyle choices and self-management
Support preventive health strategies and gap closure
Follow up after hospitalizations and significant health events to support continuity of care and prevent readmissions
Coordinate with physicians, specialists, healthcare providers, community organizations, state agencies, and service providers
Advocate for enrollee needs and preferences
Evaluate member satisfaction and monitor concerns
Conduct regular member, provider, and community-based visits
Report abuse, neglect, or exploitation as a mandated reporter
Adhere to NCQA and care management standards
Perform other related duties as requested

What you’ll need

Master's degree in social work or mental health counseling
Independent clinical license required
Licensed Clinical Social Worker (LCSW), Licensed Independent Clinical Social Worker (LISCW), or Licensed Mental Health Counselor (LMHC) required
Ability to independently serve people with complex medical, behavioral, and social needs
Prior experience in care coordination, case management, or working with dual-eligible populations preferred
Medicaid and/or Medicare managed care experience preferred
Intermediate proficiency with Microsoft Office, including Outlook, Word, and Excel
Understanding of Medicare and Medicaid programs and community resources for dual-eligible beneficiaries
Ability to manage multiple cases and priorities while maintaining attention to detail
Adherence to professional codes of ethics
Ability to function independently and as part of an interdisciplinary team
Strong written and verbal communication skills
Valid driver's license, vehicle, and verifiable insurance required
Successful driver's license record check and criminal background check required
Influenza vaccination required during influenza season
Must reside in the assigned territory and within commutable distance to the Commonwealth of Massachusetts

Comp & perks