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 9/22/2026full-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 management for dually eligible enrollees, including comprehensive assessments, care plan development, and interdisciplinary collaboration. Proficient in navigating Medicare and Medicaid programs while advocating for member needs and promoting preventive health strategies.

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 ManagementHealth EducationPreventive Care StrategiesMember AdvocacyRisk AssessmentCommunity Resource NavigationData Reporting

Soft Skills

Interpersonal SkillsCommunication SkillsCustomer Service SkillsProblem-Solving SkillsAttention to Detail

Tools & Technologies

Microsoft OfficeOutlookWordExcel

Certifications & Qualifications

Registered Nurse LicenseCase Management Certification

Industry Keywords

Dually Eligible EnrolleesLong-Term Services and SupportsNCQA StandardsCommunity-Based CareHealth Promotion

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, 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, Medicaid, chronic conditions, medication adherence, preventive care, benefits, and available services
Promote healthy lifestyle choices and self-management strategies
Support preventive health strategies and gap closure
Follow up after hospitalizations and significant health events to promote continuity of care and prevent readmissions
Coordinate care 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
Registered Nurse with the ability to independently serve people with complex medical, behavioral, and social needs required
Current unrestricted clinical license in the Commonwealth of Massachusetts as a Registered Nurse (RN) required
Must have valid driver's license, vehicle, and verifiable insurance
Successful clearance of a driver's license record check required
Annual proof of influenza vaccination required during influenza season
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
Decision-making and problem-solving skills
Awareness and sensitivity to diverse backgrounds and needs
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
Case Management Certification highly preferred
Must reside in the assigned territory and within commutable distance to the Commonwealth of Massachusetts

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
Annual influenza vaccination requirement covered as a condition of employment
Flexible hours, including possible evenings and/or weekends