Registered Nurse, Clinical Care 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-timeSpringfield • Massachusetts • United StatesMid-LevelSenior💰 $80,000 - $120,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

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 effective communication and continuity of care.

Highest-signal resume keywords

Registered Nurse (RN)Care CoordinationMedicaid Managed Care ExperienceMedicare KnowledgeInterdisciplinary Team Leadership

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Clinical AssessmentsCare Plan DevelopmentCrisis ManagementRisk AssessmentUtilization Management

Soft Skills

Strong Communication SkillsInterpersonal SkillsCustomer Service SkillsAttention to DetailAbility to Function Independently

Tools & Technologies

Microsoft OfficeOutlookWordExcel

Certifications & Qualifications

Associate of Science (A.S.) in NursingCurrent Unrestricted Clinical License in Massachusetts

Industry Keywords

Dually Eligible PopulationsCommunity ResourcesPreventive CareHealth Care TransitionsNCQA Standards

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
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 the interdisciplinary care team and create holistic care plans
Oversee utilization of long-term services and supports
Assist members with housing, transportation, food assistance, and social services
Educate members about Medicare, Medicaid, benefits, chronic-condition management, medication adherence, and preventive care
Promote healthy lifestyle choices and self-management strategies
Support preventive health strategies and gap closure
Follow up after hospitalizations and significant health events to promote continuity and prevent readmissions
Coordinate care 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 job-related duties as requested

Requirements

What you’ll need

Associate of Science (A.S.) degree in nursing from an accredited nursing program required
Registered Nurse able 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
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
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
Ability to manage multiple cases and priorities while maintaining attention to detail
Ability to function independently and effectively as part of an interdisciplinary team
Strong written and verbal communication skills
Strong interpersonal, customer relations, and customer service skills
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
Must reside in the assigned territory
Must live within commutable distance to the Commonwealth of Massachusetts

Benefits

Comp & perks

Bonus tied to company and individual performance may be available
Comprehensive total rewards package
Employee total well-being support
Reasonable accommodations for qualified individuals
Flexible hours, including possible evenings and/or weekends as needed
Annual influenza vaccination requirement covered as a condition of continued employment