Community Based Care Manager-

CareSource • Mobile, AL

9d • $62,700 - $100,400 • Onsite

About The Position

The Community Based Care Coordinator, Duals Integrated Care manages and coordinates care for dual-eligible beneficiaries who qualify for both Medicare and Medicaid. The position integrates health services and community resources to improve health outcomes and quality of life for individuals with complex health needs. It is a mobile role requiring regular travel to members, providers, and community locations, with possible travel exceeding 50% of working time. The employee must reside in the assigned territory, subject to possible business-need exceptions. Flexible hours, including possible evenings and weekends, may be needed to serve members.

The role requires a nursing degree or a bachelor's degree in a healthcare field, although equivalent relevant work experience may be accepted in lieu of the required education. Previous experience in nursing, social work, counseling, or a healthcare profession—such as discharge planning, case management, care coordination, or home/community health management—is required. A current, unrestricted clinical license in the state of practice as a Registered Nurse, Social Worker, or Clinical Counselor is required; additional state licensure may be required depending on assigned work. Case Management Certification is highly preferred. A valid driver's license, vehicle, and verifiable insurance are required, and employment is conditional on an acceptable driver's license record check. Annual influenza vaccination is required for designated positions during influenza season, with employees hired during that season given 30 days from hire to complete vaccination and verify immunization.

The position pays an annual salary in the range of $62,700 to $100,400. Employees may also qualify for a bonus tied to company and individual performance. CareSource offers a substantial and comprehensive total rewards package, but specific benefits are not listed in the posting. The organization provides reasonable accommodations through an interactive review process and is an Equal Opportunity Employer dedicated to fostering belonging and supporting individuals of all backgrounds.

Requirements

• Nursing degree from an accredited nursing program or a bachelor's degree in a healthcare field; equivalent relevant work experience may be accepted in lieu of required education.
• Previous experience in nursing, social work, counseling, or a healthcare profession, such as discharge planning, case management, care coordination, or home/community health management.
• Current, unrestricted clinical license in the state of practice as a Registered Nurse, Social Worker, or Clinical Counselor; licensure in multiple states may be required based on assigned work and state requirements.
• Intermediate proficiency with Microsoft Office, including Outlook, Word, and Excel.
• Understanding of Medicare and Medicaid programs and community resources and services available to dual-eligible beneficiaries.
• Strong interpersonal and communication skills for engaging members, families, and healthcare providers.
• Ability to manage multiple cases and priorities while maintaining attention to detail.
• Ability to adhere to a code of ethics aligned with professional practice.
• Awareness of and sensitivity to the diverse backgrounds and needs of the populations served.
• Decision-making and problem-solving skills.
• Valid driver's license, vehicle, and verifiable insurance; an acceptable driver's license record check is required.
• Annual influenza vaccination for designated positions during influenza season; employees hired during the season must complete vaccination and verify immunization within 30 days of hire.
• Ability to travel regularly and reside in the assigned territory, subject to possible exceptions based on business need.

Nice To Haves

• Prior experience in care coordination, case management, or working with dual-eligible populations.
• Medicaid and/or Medicare managed care experience.
• Case Management Certification.

Responsibilities

• Engage with members in community-based settings while considering their cultural and linguistic needs.
• Act as a liaison between healthcare providers, community resources, and dual-eligible beneficiaries to support communication and care transitions.
• Conduct comprehensive assessments of members' physical, mental, and social needs.
• Develop and implement individualized care plans addressing medical, social, and behavioral health requirements.
• Lead and collaborate with an interdisciplinary care team to create holistic care plans.
• Help members access community resources, including housing, transportation, food assistance, and social services.
• Educate members about their Medicare and Medicaid benefits and available services.
• Educate members and families about chronic condition management, medication adherence, and preventive care.
• Promote healthy lifestyle choices and self-management strategies.
• Monitor members' health status and adherence to care plans, adjusting plans as needed.
• Follow up after hospitalizations or significant health events to support continuity of care and prevent readmissions.
• Coordinate care and share relevant information with primary care physicians, specialists, and other healthcare providers.
• Coordinate with community-based organizations, stakeholders, state agencies, and service providers to support coordination and avoid duplication.
• Participate in care team meetings to discuss member progress and barriers to care.
• Maintain accurate, up-to-date records of member interactions, care plans, and outcomes.
• Collect and analyze data to evaluate care coordination effectiveness and identify improvements.
• Advocate for members' needs and preferences within the healthcare system.
• Empower members to take an active role in healthcare decisions.
• Evaluate member satisfaction through communication and monitoring concerns or issues.
• Conduct regular member, provider, and community visits as needed and in accordance with program requirements.
• Report suspected abuse, neglect, or exploitation of older adults as a mandated reporter under state law.
• Perform on-call responsibilities as assigned.
• Adhere to NCQA and CMSA standards.
• Perform other job-related duties as requested.

Benefits

• Potential bonus tied to company and individual performance.
• Substantial and comprehensive total rewards package.
• Reasonable accommodations for qualified individuals through an interactive review process.

What This Job Offers

• Job Type: Full-time