RN Care Manager

CareSource

. Engage with enrollees in homes and community settings to establish complex care management relationships .

Posted 10/7/2026full-timeRemote • 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 management for dually eligible enrollees, integrating health services and community resources to enhance patient outcomes. Proficient in conducting assessments, developing care plans, and collaborating with interdisciplinary teams while adhering to regulatory standards.

Highest-signal resume keywords

Registered Nurse LicenseCare ManagementMedicare and Medicaid KnowledgeClinical Assessment SkillsInterdisciplinary Team Collaboration

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 Care ManagementFunctional AssessmentsCrisis AssessmentsRisk AssessmentsCare Plan DevelopmentUtilization ManagementPreventive Health StrategiesCase ManagementMedication Adherence EducationCommunity Resource Coordination

Soft Skills

Strong Communication SkillsInterpersonal SkillsCustomer Service SkillsDecision-Making SkillsProblem-Solving Skills

Tools & Technologies

Microsoft OfficeOutlookWordExcel

Certifications & Qualifications

Associates of Science Degree in NursingMaster's Degree in Social Work or Mental Health CounselingCurrent Unrestricted Clinical License in Massachusetts

Industry Keywords

Dually Eligible BeneficiariesLong-Term Services and SupportsNCQA StandardsHealth Outcomes ImprovementCommunity-Based Care

About the role

Key responsibilities & impact

Engage with enrollees in homes and community settings to establish complex care management relationships
Monitor, follow up, and provide clinical care management for dually eligible enrollees with complex medical, behavioral, and social needs
Integrate health services and community resources to coordinate care and improve outcomes
Liaise 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 updates as status changes
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 about Medicare and Medicaid benefits and available services
Educate members and families about chronic conditions, medication adherence, preventive care, healthy lifestyles, 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 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
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, or Master's degree in social work or mental health counseling and independent license required
Three (3) years of experience as a Registered Nurse/BH Clinician, or one (1) year as a Registered Nurse/BH Clinician with two (2) years of experience working with people with complex medical, behavioral and social needs as an LPN, CHW, or MA
Current unrestricted clinical license in the Commonwealth of Massachusetts as an RN, LCSW, LICSW, or LMHC 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 written and verbal communication, interpersonal, customer relations, and customer service skills
Ability to manage multiple cases and priorities with attention to detail
Ability to work independently and as part of an interdisciplinary team
Awareness and sensitivity to diverse backgrounds and needs
Decision-making and problem-solving skills
Must have 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 and 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
Comprehensive total rewards package
Reasonable accommodations for qualified individuals
Flexible hours, including possible evenings and/or weekends
Mobile work arrangement with regular travel to homes, offices, and public settings