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CareSource · 1 day ago

Clinical Care Manager - Massachusetts

Boston MA Office (Avenue de Lafayette)

Full-time

Hybrid

Mid Level

$63K/yr - $100K/yr

3+ years exp

CareSource is a healthcare organization focused on providing integrated health services. The Clinical Care Manager-Massachusetts is responsible for managing care for dually-eligible enrollees with complex needs, ensuring effective communication between healthcare providers and community resources to enhance health outcomes.

Health CareMedicalNon Profit

Comp. & Benefits

H1B Sponsor Likely

Responsibilities

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

Adherence to NCQA and Care Management standards

Performs any other job related duties as requested

Qualification

Registered Nurse licenseCare coordination experienceMedicaid/Medicare knowledgeCase Management CertificationMicrosoft Office proficiencyCustomer service skillsInterpersonal skillsCommunication skillsProblem-solving skillsTeam collaboration

Required

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

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

Must have valid driver's license, vehicle and verifiable insurance. Employment in this position is conditional pending successful clearance of a driver's license record check. If the driver's license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in this position will be terminated

To help protect our employees, members, and the communities we serve from acquiring communicable diseases, 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) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified

Preferred

Prior experience in care coordination, case management, or working with dual-eligible populations preferred

Medicaid and/or Medicare managed care experience preferred

Case Management Certification is highly preferred

Benefits

You may qualify for a bonus tied to company and individual performance.

We offer a substantial and comprehensive total rewards package.

Company

CareSource

Glassdoor3.8

CareSource provides managed care services to Medicaid beneficiaries.

Founded in 1989

Dayton, Ohio, USA

1001-5000 employees

https://www.caresource.com/

H1B Sponsorship

CareSource has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2025 (30)

2024 (39)

2023 (35)

2022 (21)

2021 (37)

2020 (28)