RN Clinical Care Manager - Holyoke and surrounding areas - 5K Sign On Bonus

Clinical Care Manager – Massachusetts Job Summary: The Clinical Care Manager is a community‑based registered nurse responsible for monitoring, follow‑up and care management of dually eligible enrollees with complex medical, behavioral and social care needs. This role integrates health services and community resources to coordinate enrollee care and improve health outcomes. Essential Functions Engage with enrollees in their homes and community settings to establish an effective, complex care management relationship, considering cultural and linguistic needs. Act as liaison between healthcare providers, community resources, and enrollees to ensure seamless communication and care transitions. Perform timely assessments including 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 status changes. Lead the interdisciplinary care team and collaborate with peers to create holistic care plans addressing medical and non‑medical needs. Oversee enrollee utilization of long‑term services and supports, ensuring systems are in place for enrollees to remain in their chosen location. Assist members in accessing community resources such as housing, transportation, food assistance, and social services. Educate members and families on benefits, Medicare and Medicaid services, chronic condition management, medication adherence, and preventive care. Promote healthy lifestyle choices and self‑management strategies; assist in preventive health strategies and gap closure. Follow up after hospitalizations or significant health events to ensure continuity of care and prevent readmissions. Coordinate with primary care physicians, specialists, and other providers to share relevant information. Collaborate with community‑based organizations, state agencies, and other service providers to avoid duplication of services. Advocate for the needs and preferences of enrollees within the healthcare system. Evaluate member satisfaction through communication and monitoring of concerns or issues. Travel regularly for member, provider, and community visits as required. Report abuse, neglect or exploitation of older adults and adults with disabilities as a mandated reporter. Education and Experience Associate of Science in Nursing from an accredited program or Master’s in Social Work/mental health counseling with independent license. Three (3) years as a Registered Nurse/BH Clinician, or one (1) year as an RN/BH Clinician with two (2) years of experience working with people with complex medical, behavioral, and social needs as an LPN, CHW, or MA. Prior experience in care coordination, case management, or working with dual‑eligible populations preferred. Medicaid and/or Medicare managed care experience preferred. Competencies, Knowledge and Skills Intermediate proficiency with Microsoft Office (Outlook, Word, Excel). Understanding of Medicare and Medicaid programs and community resources for dual‑eligible beneficiaries. Strong interpersonal and communication skills for engagement with members, families, and providers. Ability to manage multiple cases and priorities with attention to detail. Adherence to professional code of ethics. Awareness of and sensitivity to diverse backgrounds and needs. Decision‑making and problem‑solving skills. Ability to work independently and as part of an interdisciplinary team. Strong customer service skills. Licensure and Certification Current unrestricted clinical license in Massachusetts as RN, LCSW, LISCW, or LMHC. Case Management Certification highly preferred. Valid driver’s license, vehicle, and verifiable insurance. Other Requirements Annual influenza vaccination required during the season (October 1 – March 31); new hires have up to 30 days to complete. Clearance of a driver’s license record check (resulting in possible offer withdrawal or termination if unacceptable). Working Conditions This is a mobile position requiring frequent travel to homes, offices, and public settings; weather exposure and long periods of standing or sitting are possible. Employees may need to work evenings or weekends. Must reside within their assigned territory, typically a commutable distance in Massachusetts. Over 50% of time may involve travel. Compensation Salary range: $90,000 – $120,000. Additional bonus may be tied to company and individual performance. Comprehensive total rewards package available. Equal Opportunity Employer CareSource is an Equal Opportunity Employer. We are dedicated to fostering a welcoming environment for individuals of all backgrounds. #J-18808-Ljbffr CareSource