Hybrid Registered Nurse; RN Clinical Care Manager - South End

Job Summary

The Integrated Care Clinical Manager – Massachusetts at Care Source/Commonwealth Care Alliance (CCA) is a community‑based RN who provides monitoring, follow‑up and clinical care management to dually‑eligible enrollees with complex medical, behavioral, and social care needs. The position focuses on integrating health services and community resources to coordinate enrollee care for improved health outcomes and enhanced quality of life.

• Engage with enrollees in homes and community settings to establish effective, complex care management relationships, 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 (e.g., Comprehensive Assessment, MDS‑HC Functional Assessments, 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 internal and external peers to create holistic care plans addressing 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 their chosen location.
• Assist members in accessing community resources (housing, transportation, food assistance, social services) and educate them about benefits and services under Medicare and Medicaid.
• Provide education on managing chronic conditions, medication adherence, preventive care, and healthy lifestyle choices.
• Assist enrollees in preventative health strategies, including 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 healthcare providers to share relevant information.
• Coordinate 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 and monitor concerns or issues.
• Regularly travel for member, provider and community visits.
• Report abuse, neglect or exploitation of older adults and adults with disabilities as a mandated reporter per state law.
• Adhere to NCQA and Care Management standards and perform other duties as requested.

• Associate of Science in Nursing from an accredited program.
• Registered Nurse licensure in Massachusetts (unrestricted).
• Prior experience in care coordination, case management, or working with dual‑eligible populations preferred.
• Medicaid and/or Medicare managed care experience preferred.
• Clinical field / community‑based training a plus.

• Intermediate proficiency with Microsoft Office (Outlook, Word, Excel).
• Understanding of Medicare, Medicaid, and community resources available to dual‑eligible beneficiaries.
• Strong interpersonal, written and verbal communication skills.
• Ability to manage multiple cases and priorities while maintaining attention to detail.
• Decision‑making and problem‑solving skills.
• Ability to function independently or as part of an interdisciplinary team.
• Customer‑service orientation.
• Awareness of and sensitivity to diverse backgrounds and needs.
• Adherence to professional ethics code.

• Current unrestricted RN license in Massachusetts.
• Case Management Certification highly preferred.
• Valid driver’s license, vehicle and verifiable insurance required.
• Influenza vaccination required during season (October1 – March
  31). Employees hired during season have 30 days to complete vaccination.

• Mobile position with regular travel to homes, offices or other public settings.
• Exposure to weather conditions typical of the area; may need to stand/sit for long periods.
• Must reside in the same territory assigned; travel over 50% of time may be required.
• Flexible hours, including evenings and/or weekends as needed.
• Must live within commutable distance to Massachusetts.

Salary range: $90,000 – $120,000. Possibility of performance‑based bonus. Comprehensive total rewards package.

Care Source is an Equal Opportunity Employer and is dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

Care Source provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Requests for accommodations are completed through an interactive review process.