Registered Nurse (RN) Clinical Care Manager
CareSource
full-time
Posted on:
Location Type: Hybrid
Location: Cambridge • 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, including but not limited to Comprehensive Assessment, MDS-HC (or successor) Functional Assessments, and Crisis and Risk Assessments
- Engage enrollees in care plan development and implementation, providing routine updates as the enrollee’s status changes
- Lead the interdisciplinary care team (ICT) and collaborate with peers both internal and external to the organization, to create holistic care plans that address medical and non-medical needs
- Oversee enrollee utilization of long-term services and supports, ensuring appropriate systems are in place for enrollees to remain in the location of their choice
- Assist members in accessing community resources, including housing, transportation, food assistance, and social services
- Educate members about their benefits and available services under both Medicare and Medicaid
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
- Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel
- Understanding of Medicare and Medicaid programs, as well community resources and services available to dual-eligible beneficiaries
- Ability to manage multiple cases and priorities while maintaining attention to detail
- Adhere to code of ethics that aligns with professional practice
- Awareness of and sensitivity to the diverse backgrounds and needs of the populations served
- Decision making and problem-solving skills
- Ability to function independently and effectively as part of an interdisciplinary team
Benefits
- Comprehensive total rewards package
- Annual proof of Influenza vaccination required
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
Comprehensive AssessmentMDS-HC Functional AssessmentsCrisis Assessmentscare coordinationcase managementdual-eligible populationsnursingmental health counselinglong-term services and supportscommunity resource access
Soft Skills
communicationattention to detaildecision makingproblem-solvingindependencecollaborationleadershipsensitivity to diverse backgroundsorganizational skillsinterpersonal skills
Certifications
Associates of Science (A.S) degree in nursingMaster's degree in social workindependent license