Registered Nurse (RN), Clinical Care Manager

CareSource

Community based Registered Nurse (RN) Clinical Care Manager engaging with dually-eligible enrollees. Focuses on health coordination and community resource integration for better health outcomes.

Posted 6/3/2026full-timeBoston • Massachusetts • 🇺🇸 United StatesMid-LevelSenior💰 $90,000 - $120,000 per yearWebsite

About the role

Key responsibilities & impact

Engage with the enrollee in their homes and other community settings to establish an effective, complex care management relationship, while considering the cultural and linguistic needs of each member.
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.
Provide education to members and their families about managing chronic conditions, medication adherence, and preventive care.
Promote healthy lifestyle choices and self-management strategies.
Assist enrollees in preventative health strategies, including gap closure
Follow up with members after hospitalizations or significant health events to ensure continuity of care and prevent readmissions.
Work closely with primary care physicians, specialists, and other healthcare providers to coordinate care and share relevant information.
Coordinate with community-based organizations, other stakeholders/entities, state agencies, and other service providers to ensure coordination and avoid duplication of services.
Advocate for the needs and preferences of enrollees within the healthcare system.
Evaluate member satisfaction through open communication and monitoring of concerns or issues.
Regular travel to conduct member, provider and community-based visits as required
Report abuse, neglect, or exploitation of older adults and adults with disabilities as a mandated reporter as required by State law.

Requirements

What you’ll need

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.
Strong interpersonal and communication skills to effectively engage with members, families, and healthcare providers
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

Comp & perks

Influenza vaccination is a requirement of this position.
Health insurance
401(k) matching
Flexible work hours
Paid time off
Professional development opportunities

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

care coordinationcase managementcomprehensive assessmentMDS-HC functional assessmentscrisis assessmentschronic condition managementmedication adherencepreventive caregap closurereporting abuse and neglect

Soft Skills

interpersonal skillscommunication skillsattention to detaildecision makingproblem-solvingadvocacycultural sensitivityindependenceteam collaborationmember engagement

Certifications

Registered Nurse (RN)Licensed Practical Nurse (LPN)Community Health Worker (CHW)Medical Assistant (MA)independent license in social work or mental health counseling