Registered Nurse, Clinical Care Manager

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🕒 3 days ago

🏢🏡 Boston – Hybrid

💵 $90k - $120k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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CareSource

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 30+ years

⚕️ Healthcare Insurance

Healthcare Insurance

CareSource is a health services company focused on providing affordable health insurance and healthcare solutions. It offers a wide range of plans including Medicaid, Marketplace, and Medicare Advantage, targeting low-income adults, families, children, pregnant women, elderly adults, and people with disabilities. Additionally, CareSource provides members with resources for COVID-19 support, dental, vision, and hearing benefits, as well as pharmacy services. The company emphasizes easy access to healthcare management through online platforms and a mobile app.

📋 Description

• 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. • 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. • Provide education to members and their families about managing chronic conditions, medication adherence, and preventive care. • Follow up with members after hospitalizations or significant health events.

🎯 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. • Current unrestricted clinical license in the Commonwealth of Massachusetts as a Registered Nurse (RN), Licensed Clinical Social Worker (LCSW), Licensed Independent Clinical Social Worker (LISCW), or a Licensed Mental Health Counselor (LMHC) required. • Case Management Certification is highly preferred. • Must have valid driver's license, vehicle and verifiable insurance.

🏖️ Benefits

• Influenza vaccination is a requirement of this position. • CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 – March 31). • Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our members. • CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law.