Registered Nurse (RN) Clinical Care Manager

CareSource

Registered Nurse managing complex clinical care for dually-eligible enrollees at CareSource. Engaging in community settings and working closely with interdisciplinary teams.

Posted 7/30/2026full-timeWilbraham • Massachusetts • 🇺🇸 United StatesMid-LevelSenior💰 $80,000 - $120,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in care coordination and case management, particularly for dual-eligible populations, while effectively engaging with enrollees and healthcare providers. Proficient in conducting comprehensive assessments and creating holistic care plans that address both medical and non-medical needs.

Highest-signal resume keywords

Registered Nurse (RN)Care CoordinationMedicaid ExperienceMedicare ExperienceInterdisciplinary Team Collaboration

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Comprehensive AssessmentMDS-HC Functional AssessmentCrisis AssessmentRisk AssessmentCare Plan DevelopmentClinical Field TrainingCase ManagementCommunity Resource AccessUtilization ManagementAttention to Detail

Soft Skills

Interpersonal SkillsCommunication SkillsDecision MakingProblem SolvingSensitivity to Diverse Backgrounds

Tools & Technologies

Microsoft OfficeOutlookWordExcel

Certifications & Qualifications

Associates of Science (A.S) in NursingRegistered Nurse License

Industry Keywords

Healthcare ProvidersCommunity ResourcesLong-Term Services and SupportsMedicareMedicaidCare TransitionsHolistic CareSelf-Management StrategiesContinuity of CareDual-Eligible Populations

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
Function as a liaison between healthcare providers, community resources, and enrollees to ensure seamless communication and care transitions
Perform required assessments including Comprehensive Assessment, MDS-HC (or successor) Functional Assessments, and Crisis and Risk Assessments
Lead the interdisciplinary care team (ICT) and collaborate with peers 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, and social services
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 to ensure continuity of care and prevent readmissions
Work closely with primary care physicians and specialists to coordinate care
Advocate for the needs and preferences of enrollees within the healthcare system

Requirements

What you’ll need

Associates of Science (A.S) degree in nursing from an accredited nursing program required
A Registered Nurse with the ability to independently serve people with complex medical, behavioral, and social needs.
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 level with Microsoft Office, including Outlook, Word and Excel.
Understanding of Medicare and Medicaid programs
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

Health insurance
401(k) matching
Flexible work hours
Paid time off
Remote work options