RN Care Manager

CareSource

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

Posted 9/22/2026full-timeSpringfield • 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, focusing on complex medical, behavioral, and social needs. Proficient in developing care plans, conducting assessments, and coordinating with healthcare providers and community resources.

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 Care ManagementCrisis AssessmentRisk AssessmentCare Plan DevelopmentUtilization ManagementPreventive Health StrategiesCommunity Resource LiaisonMember EducationCultural CompetencyMandated Reporting

Soft Skills

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

Tools & Technologies

Microsoft OfficeOutlookWordExcel

Certifications & Qualifications

Registered Nurse LicenseCase Management CertificationAnnual Influenza Vaccination

Industry Keywords

Dually Eligible BeneficiariesLong-Term Services and SupportsHealthcare Provider LiaisonCommunity-Based CareNCQA 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 needs
Engage enrollees in their homes and community settings while considering cultural and linguistic needs
Liaise between healthcare providers, community resources, and enrollees to support communication and care transitions
Complete 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
Help members access 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 close care gaps
Follow up after hospitalizations and significant health events to promote continuity and prevent readmissions
Coordinate care with primary care 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 under state law
Adhere to NCQA and Care Management standards
Perform other 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
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
Knowledge of professional code of ethics
Awareness and sensitivity to diverse backgrounds and population needs
Decision-making and problem-solving skills
Valid driver's license, vehicle, and verifiable insurance required
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 Massachusetts
Must be able to travel over 50% of the time
Prior care coordination, case management, or dual-eligible population experience preferred
Medicaid and/or Medicare managed care experience preferred
Clinical field/community-based training is a plus
Case Management Certification highly preferred

Benefits

Comp & perks

$5,000 sign-on bonus
Bonus tied to company and individual performance may be available
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
Mobile work arrangement with regular travel to homes, offices, and public settings