Registered Nurse (RN) 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 10/16/2026full-timeBoston • 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 enrollees, focusing on complex medical, behavioral, and social needs. Proficient in developing and implementing comprehensive care plans while effectively collaborating with interdisciplinary teams and community resources.

Highest-signal resume keywords

Registered Nurse (RN)Care CoordinationMedicaid ExperienceMedicare ExperienceClinical Field Training

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Functional AssessmentsCrisis AssessmentsRisk AssessmentsCare Plan DevelopmentUtilization ManagementPreventive Health StrategiesCase ManagementCommunity Resource CoordinationMember EducationAttention to Detail

Soft Skills

Strong Communication SkillsIndependent FunctioningTeam CollaborationAdvocacy

Tools & Technologies

Microsoft OfficeOutlookWordExcel

Certifications & Qualifications

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

Industry Keywords

Dually Eligible PopulationsLong-Term Services and SupportsNCQA StandardsCommunity-Based ServicesHealthcare Provider Liaison

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, 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
Assist members with housing, transportation, food assistance, and social services
Educate members about Medicare, Medicaid, chronic conditions, medication adherence, preventive care, healthy lifestyles, and self-management
Support preventive health strategies and gap closure
Follow up after hospitalizations or significant health events to ensure continuity of care and prevent readmissions
Coordinate care with primary care 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
Report abuse, neglect, or exploitation as a mandated reporter under state law
Adhere to NCQA and Care Management standards
Perform other job-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
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, 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
Current valid driver's license, vehicle, and verifiable insurance
Successful clearance of a driver's license record check
Annual Influenza vaccination during Influenza season as a condition of continued employment
Must reside in the same assigned territory; must live within commutable distance to the Commonwealth of Massachusetts
Ability to travel greater than 50% of the time

Benefits

Comp & perks

$5,000 sign-on bonus
Bonus tied to company and individual performance
Substantial and comprehensive total rewards package
Reasonable accommodations for qualified individuals with disabilities, medical conditions, or sincerely held religious beliefs
Flexible hours, including possible evenings and/or weekends as needed
Influenza vaccination provided as a condition of continued employment compliance
Mobile work with travel to homes, offices, and public settings
Professional collaboration and development through interdisciplinary team participation