Integrated Care Clinical Manager, RN

CareSource

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

Posted 10/14/2026full-timeLynn • Massachusetts • United StatesMid-LevelSenior💰 $80,000 - $120,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in care management for dually eligible enrollees, including the development and implementation of comprehensive care plans, coordination with healthcare providers, and advocacy for member needs. Proficient in assessing complex medical, behavioral, and social care needs while ensuring adherence to regulatory standards.

Highest-signal resume keywords

Registered Nurse (RN)Care CoordinationCase Management CertificationMedicare and Medicaid KnowledgeInterdisciplinary Team Collaboration

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Comprehensive AssessmentsCrisis and Risk AssessmentsCare Plan DevelopmentUtilization ManagementPreventive Health Strategies

Soft Skills

Interpersonal SkillsCommunication SkillsCustomer Service SkillsDecision-Making SkillsProblem-Solving Skills

Tools & Technologies

Microsoft OfficeOutlookWordExcel

Certifications & Qualifications

Case Management CertificationCurrent Unrestricted Clinical License

Industry Keywords

Dually Eligible EnrolleesLong-Term Services and SupportsNCQA StandardsCommunity ResourcesHealth Event Follow-Up

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 routine updates
Lead interdisciplinary care teams and create holistic care plans addressing medical and non-medical needs
Oversee utilization of long-term services and supports
Help members access housing, transportation, food assistance, and social services
Educate members and families about Medicare, Medicaid, chronic conditions, medication adherence, preventive care, healthy lifestyles, and self-management
Assist with 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 other service providers
Advocate for enrollee needs and preferences
Evaluate member satisfaction and monitor concerns
Conduct regular member, provider, and community-based visits, with travel potentially exceeding 50% of work time
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

Associates of Science (A.S.) degree in nursing from an accredited nursing program required
Registered Nurse with the ability to independently serve people with complex medical, behavioral, and social needs
Current unrestricted clinical license in the Commonwealth of Massachusetts as a Registered Nurse (RN) required
Intermediate proficiency with Microsoft Office, including Outlook, Word, and Excel
Understanding of Medicare and Medicaid programs and community resources and services available to 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 effectively as part of an interdisciplinary team
Decision-making and problem-solving skills
Awareness of and sensitivity to diverse backgrounds and needs
Valid driver's license, vehicle, and verifiable insurance required
Successful driver's license record check required
Influenza vaccination required during influenza season
Must reside in the assigned territory and within commutable distance to the Commonwealth of Massachusetts
Prior experience in care coordination, case management, or working with dual-eligible populations preferred
Medicaid and/or Medicare managed care experience preferred
Clinical field/community-based training a plus
Case Management Certification highly preferred

Benefits

Comp & perks

Bonus tied to company and individual performance may be available
Comprehensive total rewards package
Flexible hours, including possible evenings and/or weekends as needed
Reasonable accommodations for qualified individuals with disabilities, medical conditions, or sincerely held religious beliefs
Annual influenza vaccination requirement and verification during influenza season