Integrated Care Clinical Manager – BH

CareSource

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

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

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in clinical care management for dually eligible enrollees, integrating health services and community resources while leading interdisciplinary teams. Proficient in conducting assessments, developing care plans, and advocating for member needs within the frameworks of Medicare and Medicaid.

Highest-signal resume keywords

Licensed Clinical Social Worker (LCSW)Independent Clinical LicenseCase Management CertificationMedicare and Medicaid KnowledgeInterdisciplinary Team Leadership

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Clinical Care ManagementCrisis AssessmentRisk AssessmentCare Plan DevelopmentUtilization ManagementComplex Case ManagementPreventive Health StrategiesCommunity Resource CoordinationMember Satisfaction EvaluationHealth Education

Soft Skills

Interpersonal SkillsCommunication SkillsCustomer Service SkillsDecision-Making SkillsProblem-Solving Skills

Tools & Technologies

Microsoft OfficeOutlookWordExcel

Certifications & Qualifications

Licensed Independent Clinical Social Worker (LISCW)Licensed Mental Health Counselor (LMHC)

Industry Keywords

Dually Eligible EnrolleesLong-Term Services and SupportsNCQA StandardsCommunity-Based CareSocial 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 needs
Integrate health services and community resources to coordinate enrollee care
Engage enrollees in homes and community settings to establish complex care management relationships
Liaise between healthcare providers, community resources, and enrollees to support communication and care transitions
Perform comprehensive, functional, crisis, and risk assessments
Develop and implement care plans with enrollees and provide updates as status changes
Lead interdisciplinary care teams and create holistic care plans
Oversee utilization of long-term services and supports
Help members access housing, transportation, food assistance, and social services
Educate members about Medicare, Medicaid, chronic-condition management, 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 ensure continuity and prevent readmissions
Coordinate care with physicians, specialists, healthcare providers, community organizations, state agencies, and other stakeholders
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 under state law
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 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
Intermediate proficiency with Microsoft Office, including Outlook, Word, and Excel
Understanding of Medicare and Medicaid programs and community resources for dual-eligible beneficiaries
Strong interpersonal, communication, customer relations, 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
Adherence to a professional code of ethics
Awareness and sensitivity to diverse backgrounds and needs
Decision-making and problem-solving skills
Case Management Certification highly preferred
Valid driver's license, vehicle, and verifiable insurance required
Successful driver's license record check required
Annual influenza vaccination required during influenza season
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

Benefits

Comp & perks

Bonus tied to company and individual performance may be available
Substantial and comprehensive total rewards package
Reasonable accommodations for qualified individuals
Annual influenza vaccination requirement covered as a condition of continued employment
Flexible hours, including possible evenings and/or weekends as needed to serve members