Hybrid RN Clinical Care Manager - Whitman-R13461 Hybrid RN Clinical Care Manager - Fall River$5k SIGN ON BONUS
$80,000–$120,000 year
On-siteBrockton, Massachusetts, United States
Job Summary
Conduct comprehensive clinical care management for dually-eligible enrollees with complex medical, behavioral, and social needs by engaging members in their homes and community settings. Perform required assessments including MDS-HC and crisis evaluations, lead interdisciplinary care teams to develop holistic care plans, and oversee utilization of long-term services and supports. Coordinate seamless care transitions between healthcare providers, community resources, and state agencies while advocating for enrollee preferences. Assist members in accessing housing, transportation, and food assistance, educate families on chronic condition management and preventive care, and follow up post-hospitalization to prevent readmissions. Report abuse or neglect as a mandated reporter and adhere to NCQA standards. This mobile role requires regular travel exceeding 50% of the time, flexible hours including evenings and weekends, and resides in Fall River, Massachusetts.
Required Qualifications
- Associates of Science (A.S) degree in nursing from an accredited nursing program
- Current unrestricted clinical license in the Commonwealth of Massachusetts as a Registered Nurse (RN)
- Valid driver's license, vehicle and verifiable insurance
- Influenza vaccination
- Must reside in the same territory they are assigned to work in
- Must live within commutable distance to the Commonwealth of Massachusetts
- 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
- 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
- Strong and effective communication skills, both written and verbal
- Strong interpersonal and customer relations skills
- Strong customer service skills
- Must be able to lift 50 lbs
Desired Qualifications
- Prior experience in care coordination, case management, or working with dual-eligible populations
- Medicaid and/or Medicare managed care experience
- Clinical Field/ Community Based Training
- Case Management Certification
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