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 10/8/2026full-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 coordination and management for dually eligible enrollees, with a strong focus on developing and implementing comprehensive care plans. Proficient in engaging with diverse populations and collaborating with interdisciplinary teams to ensure continuity of care and adherence to healthcare standards.

Highest-signal resume keywords

Registered Nurse (RN)Care CoordinationMedicaid and Medicare ExperienceClinical Field TrainingInterpersonal Communication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Care ManagementCrisis AssessmentFunctional AssessmentCare Plan DevelopmentUtilization ManagementMedication Adherence EducationPreventive Health StrategiesCase ManagementCommunity Resource CoordinationMember Satisfaction Evaluation

Soft Skills

Strong Interpersonal SkillsDecision-Making SkillsProblem-Solving SkillsAttention to DetailCustomer Service Skills

Tools & Technologies

Microsoft OfficeOutlookWordExcel

Certifications & Qualifications

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

Industry Keywords

Dually Eligible PopulationsNCQA StandardsCommunity-Based ServicesHealthcare Provider LiaisonSocial Services

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 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, and Crisis and Risk Assessments
Develop and implement care plans with enrollees and provide updates as status changes
Lead interdisciplinary care teams and create holistic care plans
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-condition management, medication adherence, and preventive care
Promote healthy lifestyle choices and self-management strategies
Support preventive health strategies and gap closure
Follow up after hospitalizations and significant health events to ensure continuity 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
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 and community resources and services available to dual-eligible beneficiaries
Strong interpersonal and communication skills
Ability to manage multiple cases and priorities while maintaining attention to detail
Adherence to a professional code of ethics
Awareness of and sensitivity to diverse backgrounds and needs
Decision-making and problem-solving skills
Ability to function independently and as part of an interdisciplinary team
Strong written and verbal communication skills
Strong interpersonal, customer relations, and customer service skills
Must have valid driver's license, vehicle, and verifiable insurance
Successful clearance of a 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

Benefits

Comp & perks

Bonus tied to company and individual performance may be available
Comprehensive total rewards package
Flexible hours, including possible evenings and/or weekends as needed
Reasonable accommodations for qualified individuals
Annual influenza vaccination provided/required as a condition of continued employment