Integrated Care Clinical Manager

CareSource

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

Posted 10/9/2026full-timeGreenfield • Massachusetts • United StatesMid-LevelSenior💰 $80,000 - $120,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in care coordination and management for dually eligible populations, with a strong focus on developing and implementing comprehensive care plans. Proficient in engaging with enrollees and healthcare providers to ensure continuity of care and adherence to Medicare and Medicaid standards.

Highest-signal resume keywords

Licensed Clinical Social Worker (LCSW)Care CoordinationMedicaid and Medicare ExperienceInterdisciplinary Team LeadershipComplex Care Management

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Functional AssessmentsCrisis and Risk AssessmentsCare Plan DevelopmentUtilization ManagementCommunity Resource Coordination

Soft Skills

Interpersonal SkillsCommunication SkillsDecision-MakingProblem-SolvingCustomer Service

Tools & Technologies

Microsoft OfficeOutlookWordExcel

Certifications & Qualifications

Master's Degree in Social WorkIndependent LicenseLicensed Independent Clinical Social Worker (LISCW)Licensed Mental Health Counselor (LMHC)

Industry Keywords

Dually Eligible EnrolleesLong-Term Services and SupportsPreventive Health StrategiesNCQA StandardsCommunity-Based Services

About the role

Key responsibilities & impact

Provide monitoring, follow-up, and clinical care management to dually eligible enrollees with complex medical, behavioral, and social care needs
Engage enrollees in their homes and community settings to establish complex care management relationships
Serve as liaison between healthcare providers, community resources, and enrollees
Perform Comprehensive, MDS-HC or successor Functional, and Crisis and Risk Assessments
Develop and implement care plans with enrollees and provide updates as statuses change
Lead interdisciplinary care teams and create holistic care plans addressing medical and non-medical needs
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 on chronic conditions, medication adherence, preventive care, healthy lifestyles, and self-management
Support preventive health strategies and gap closure
Follow up after hospitalizations and significant health events to promote continuity of care and prevent readmissions
Coordinate care with primary care 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

Requirements

What you’ll need

Master's degree in social work or mental health counseling
Independent 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 available to dual-eligible beneficiaries
Strong interpersonal, communication, decision-making, problem-solving, and customer service skills
Ability to manage multiple cases and priorities while maintaining attention to detail
Ability to function independently and as part of an interdisciplinary team
Must have a valid driver's license, vehicle, and verifiable insurance
Successful driver's license record check required
Annual Influenza vaccination required during Influenza season (October 1–March 31)
Must reside in the assigned territory
Must live within commutable distance to the Commonwealth of Massachusetts
Ability to travel greater than 50% of the time
Flexible availability, including possible evenings and weekends

Benefits

Comp & perks

Bonus tied to company and individual performance may be available
Comprehensive total rewards package
Reasonable accommodations for qualified individuals
Flexible hours, including possible evenings and/or weekends as needed
Annual Influenza vaccination requirement with 30 days from hire to complete vaccination for employees hired during Influenza season