Hybrid RN Care Manager - Western, MA - $5K SIGN ON BONUS!
$80,000–$120,000 year
On-siteSpringfield, Massachusetts, United States or Chicopee, Massachusetts, United States
Job Summary
Conduct comprehensive care management for dually-eligible enrollees with complex medical, behavioral, and social needs by engaging members in homes and community settings. Perform required assessments including MDS-HC and crisis evaluations, lead interdisciplinary care teams to develop holistic care plans, and oversee long-term services and supports. Function as a liaison between healthcare providers, community resources, and enrollees to coordinate seamless care transitions and prevent readmissions. Assist members in accessing housing, transportation, and food assistance while educating them on Medicare and Medicaid benefits, chronic condition management, and preventative strategies. Report abuse or neglect as a mandated reporter and adhere to NCQA standards. This mobile role requires regular travel to homes and offices, flexible hours including evenings and weekends, and must be performed by a Registered Nurse with a valid Massachusetts license.
Required Qualifications
- Associates of Science (A.S) degree in nursing from an accredited nursing program
- 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
- Medicaid and/or Medicare managed care experience
- 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
- Adherence 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
- Strong and effective communication skills, both written and verbal
- Strong interpersonal and customer relations skills
- Strong customer service skills
- Current unrestricted clinical license in the Commonwealth of Massachusetts as a Registered Nurse (RN)
- Valid driver's license, vehicle and verifiable insurance
- Influenza vaccination
Desired Qualifications
- Case Management Certification
- Clinical Field/ Community Based Training
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