Registered Nurse (RN), Clinical Care Manager
CareSource
full-time
Posted on:
Location Type: Hybrid
Location: Scituate • Massachusetts • United States
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Salary
💰 $90,000 - $120,000 per year
About the role
- Engage with the enrollee in their homes and other community settings to establish an effective, complex care management relationship
- Function as a liaison between healthcare providers, community resources, and enrollees to ensure seamless communication and care transitions
- Perform required assessments on a timely basis
- Engage enrollees in care plan development and implementation
- Lead the interdisciplinary care team (ICT) and collaborate with peers both internal and external to the organization
- Oversee enrollee utilization of long-term services and supports
- Assist members in accessing community resources
- Educate members about their benefits and available services under both Medicare and Medicaid
- Promote healthy lifestyle choices and self-management strategies
- Follow up with members after hospitalizations or significant health events
- Report abuse, neglect, or exploitation of older adults and adults with disabilities as a mandated reporter as required by State law.
Requirements
- Associates of Science (A.S) degree in nursing from an accredited nursing program required or Master's degree in social work or mental health counseling and independent license required
- Three (3) years of experience as a Registered Nurse/BH Clinician or One (1) year as a Registered Nurse/BH Clinician with two (2) years of experience working with people with complex medical, behavioral and social needs as an LPN, CHW, MA required
- Prior experience in care coordination, case management, or working with dual-eligible populations preferred
- Medicaid and/or Medicare managed care experience preferred
- Understanding of Medicare and Medicaid programs, as well community resources and services available to dual-eligible beneficiaries.
- Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel.
- Must have valid driver's license, vehicle and verifiable insurance.
Benefits
- Health insurance
- Retirement plans
- Flexible work arrangements
- Paid time off
- Professional development
- Bonuses
- Influenza vaccination requirement
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
care coordinationcase managementassessmentscare plan developmentinterdisciplinary care team leadershiputilization managementcommunity resource accesshealth educationreporting abuseunderstanding of Medicare and Medicaid
Soft Skills
communicationcollaborationrelationship buildingproblem-solvingleadershiporganizational skillsempathyself-management promotionfollow-upadvocacy
Certifications
Associates of Science (A.S) in nursingMaster's degree in social workMaster's degree in mental health counselingindependent license