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 10/28/2026full-timeLowell • 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 Health StrategiesMember AdvocacyCommunity Resource NavigationRisk AssessmentAttention to Detail

Soft Skills

Interpersonal SkillsCommunication SkillsCustomer Service SkillsAbility to Manage Multiple CasesFlexibility

Tools & Technologies

Microsoft OfficeOutlookWordExcel

Certifications & Qualifications

Registered Nurse LicenseCase Management CertificationAnnual Influenza Vaccination

Industry Keywords

Dually Eligible EnrolleesLong-Term Services and SupportsCommunity-Based CareHealthcare Provider LiaisonNCQA 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 care needs
Engage enrollees in homes and community settings while considering cultural and linguistic needs
Serve as liaison among healthcare providers, community resources, and enrollees
Perform comprehensive, functional, crisis, and risk assessments
Develop and implement care plans and provide routine updates
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 and families about Medicare, Medicaid, chronic conditions, medication adherence, preventive care, benefits, and available services
Promote healthy lifestyle choices, self-management, and preventive health strategies including gap closure
Follow up after hospitalizations and significant health events to support continuity of care 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 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 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 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
Valid driver's license, vehicle, and verifiable insurance required
Successful driver's license record check required
Annual influenza vaccination required for designated positions during influenza season
Must reside in the assigned territory and within commutable distance to the Commonwealth of Massachusetts
Willingness and ability to travel more than 50% of the time
Flexible availability, including possible evenings and/or weekends
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

Bonus tied to company and individual performance may be available
Comprehensive total rewards package
Flexible hours, including possible evenings and/or weekends as needed to serve members
Reasonable accommodations for qualified individuals with disabilities, medical conditions, or sincerely held religious beliefs
Annual influenza vaccination requirement and immunization verification support