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 9/22/2026full-timeSpringfield • Massachusetts • United StatesMid-LevelSenior💰 $90,000 - $120,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in care coordination and management for dually eligible populations, with a strong focus on developing and implementing comprehensive care plans. Proficient in engaging with interdisciplinary teams and community resources to support holistic health outcomes.

Highest-signal resume keywords

Registered Nurse (RN)Care CoordinationMedicaid and Medicare ExperienceClinical AssessmentInterdisciplinary Team Leadership

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Care ManagementCrisis AssessmentRisk AssessmentCare Plan DevelopmentUtilization ManagementCommunity Resource LiaisonMedication Adherence EducationPreventive Care StrategiesCase ManagementField/Community Based Training

Soft Skills

Interpersonal SkillsCommunication SkillsCustomer Service SkillsDecision-Making SkillsProblem-Solving Skills

Tools & Technologies

Microsoft OfficeOutlookWordExcel

Certifications & Qualifications

Registered Nurse LicenseAnnual Influenza Vaccination

Industry Keywords

Dually Eligible PopulationsNCQA StandardsHealthcare ProvidersCommunity OrganizationsSocial ServicesPreventive HealthContinuity of CareHealth Event Follow-UpEthical StandardsDiverse Background Awareness

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
Liaise between healthcare providers, community resources, and enrollees to support communication and care transitions
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 create holistic care plans
Oversee utilization of long-term services and supports
Help members access housing, transportation, food assistance, and social services
Educate members about Medicare, Medicaid, chronic-condition management, medication adherence, preventive care, and available benefits
Promote healthy lifestyles and self-management strategies
Support preventive-health strategies and gap closure
Follow up after hospitalizations and significant health events to support 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 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
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
Ability to manage multiple cases and priorities while maintaining attention to detail
Ability to function independently and effectively as part of an interdisciplinary team
Strong interpersonal, communication, customer relations, and customer service skills
Adherence to a professional code of ethics
Awareness of and sensitivity to diverse backgrounds and needs of populations served
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 the Commonwealth of Massachusetts

Benefits

Comp & perks

$5K sign-on bonus
Bonus tied to company and individual performance may be available
Substantial and comprehensive total rewards package
Reasonable accommodations for qualified individuals
Annual influenza vaccination provided/required as a condition of continued employment
Flexible hours, including possible evenings and/or weekends