Registered Nurse (RN) Care Manager

CareSource

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

Posted 9/24/2026full-timeLowell • 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 comprehensive assessments, care plan development, and coordination of services. Proficient in engaging with interdisciplinary teams and community resources to enhance member satisfaction and health outcomes.

Highest-signal resume keywords

Registered Nurse (RN)Care CoordinationMedicare and Medicaid KnowledgeCase Management CertificationInterdisciplinary Team Collaboration

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Clinical AssessmentsCare Plan DevelopmentCrisis ManagementUtilization ManagementPreventive Health Strategies

Soft Skills

Interpersonal SkillsCommunication SkillsCustomer Service SkillsAttention to DetailAbility to Manage Multiple Cases

Tools & Technologies

Microsoft OfficeOutlookWordExcel

Certifications & Qualifications

Case Management CertificationRegistered Nurse License

Industry Keywords

Dually Eligible BeneficiariesLong-Term Services and SupportsCommunity ResourcesNCQA StandardsClinical Field Training

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 homes and community settings to establish complex care management relationships
Liaise between healthcare providers, community resources, and enrollees to coordinate communication and care transitions
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 and families about Medicare, Medicaid, chronic conditions, medication adherence, preventive care, and healthy lifestyles
Support preventive health strategies and close care gaps
Follow up after hospitalizations and significant health events to promote continuity and prevent readmissions
Coordinate with physicians, specialists, 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

Associates 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
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
Valid driver's license, vehicle, and verifiable insurance
Successful clearance of a driver's license record check
Annual influenza vaccination required during influenza season
Must reside in the assigned territory and within commutable distance to the Commonwealth of Massachusetts
Prior care coordination, case management, or dual-eligible population experience preferred
Medicaid and/or Medicare managed care experience preferred
Clinical Field/Community Based Training a plus
Case Management Certification highly preferred

Benefits

Comp & perks

$5K sign-on bonus
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
Annual influenza vaccination covered as a condition of employment