RN Care Manager

CareSource

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

Posted 9/15/2026full-timeStoughton • 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 dual-eligible enrollees, including comprehensive assessments, care plan development, and coordination of services. Proficient in engaging with diverse populations and advocating for member needs while adhering to regulatory standards.

Highest-signal resume keywords

Registered Nurse (RN)Care CoordinationCase Management CertificationMedicare and Medicaid KnowledgeInterdisciplinary Team Leadership

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Comprehensive AssessmentsCare Plan DevelopmentCrisis AssessmentRisk AssessmentUtilization ManagementPreventive Health StrategiesMedication Adherence EducationCommunity Resource CoordinationMember Satisfaction EvaluationTravel for Home Visits

Soft Skills

Interpersonal SkillsCommunication SkillsCustomer Service SkillsDecision-Making SkillsProblem-Solving Skills

Tools & Technologies

Microsoft OfficeOutlookWordExcel

Certifications & Qualifications

Case Management CertificationRegistered Nurse LicenseAnnual Influenza Vaccination

Industry Keywords

Dual-Eligible EnrolleesLong-Term Services and SupportsNCQA StandardsCommunity-Based TrainingHealthcare Provider Coordination

About the role

Key responsibilities & impact

Provide monitoring, follow-up, and clinical care management to dual-eligible enrollees with complex medical, behavioral, and social needs
Engage enrollees in homes and community settings and establish complex care management relationships
Coordinate communication and care transitions among healthcare providers, community resources, and enrollees
Perform Comprehensive, MDS-HC or successor Functional, Crisis, and Risk Assessments
Develop, implement, and update enrollee care plans
Lead interdisciplinary care teams and create holistic 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, benefits, chronic conditions, medication adherence, preventive care, and self-management
Support preventive health strategies and gap closure
Follow up after hospitalizations and significant health events to promote continuity of care 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, with travel over 50% of the time as required
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

Associate of Science (A.S.) degree in nursing from an accredited nursing program required
Registered Nurse with 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
Intermediate proficiency with Microsoft Office, including Outlook, Word, and Excel
Understanding of Medicare and Medicaid programs, community resources, and services 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 effectively as part of an interdisciplinary team
Decision-making and problem-solving skills
Awareness of and sensitivity to diverse backgrounds and needs
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
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

$5,000 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
Mobile work arrangement
Influenza vaccination provided as a condition of continued employment support/compliance