Integrated Care Clinical Manager - RN - Lynn, MA

CareSource • Lynn, MA

27d • $80,000 - $120,000 • Onsite

About The Position

The Integrated Care Clinical Manager is a community-based registered nurse who provides monitoring, follow-up, and clinical care management to dually eligible enrollees with complex medical, behavioral, and social care needs. The position integrates health services and community resources to coordinate care and improve health outcomes and quality of life. The role is mobile, with regular travel to members, providers, and community settings, and requires residence within commuting distance of Massachusetts and generally within the assigned territory. Travel may exceed 50% of working time. Flexible hours, including possible evenings and weekends, may be needed to serve members.

The manager leads interdisciplinary care teams, develops and updates holistic care plans with enrollees, coordinates healthcare and community services, and advocates for enrollee needs and preferences. The role also includes assessments, education, utilization oversight, post-hospital follow-up, and mandated reporting of abuse, neglect, or exploitation. The position requires an unrestricted Massachusetts RN license, an associate degree in nursing, a valid driver’s license, a vehicle, and verifiable insurance. Annual influenza vaccination is required for designated positions during influenza season.

The stated compensation range is $80,000–$120,000, with potential eligibility for a bonus tied to company and individual performance. The employer describes a substantial and comprehensive total rewards package but does not specify its individual benefits.

Requirements

• Associate of Science degree in nursing from an accredited nursing program.
• Registered Nurse able to independently serve people with complex medical, behavioral, and social needs.
• Current unrestricted Registered Nurse license in the Commonwealth of Massachusetts.
• 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.
• Adherence 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.
• Ability to work independently and effectively as part of an interdisciplinary team.
• Strong written and verbal communication, interpersonal, customer relations, and customer service skills.
• Valid driver’s license, vehicle, and verifiable insurance; employment is conditional on an acceptable driver’s license record check.
• Annual proof of influenza vaccination for designated positions during influenza season, subject to the stated hire-date timeframe for employees hired during the season.
• Must reside within commuting distance of the Commonwealth of Massachusetts; the posting also states that the employee must reside in the assigned territory, with exceptions potentially considered based on business need.
• Ability to travel regularly, potentially more than 50% of the time, and work flexible hours, including possible evenings and weekends as needed.

Nice To Haves

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

Responsibilities

• Engage with enrollees in their homes and other community settings, taking cultural and linguistic needs into account, to establish complex care management relationships.
• Act as a liaison among healthcare providers, community resources, and enrollees to support communication and care transitions.
• Complete required assessments on time, including Comprehensive Assessments, MDS-HC (or successor) Functional Assessments, and Crisis and Risk Assessments.
• Engage enrollees in developing and implementing care plans and update plans as their status changes.
• Lead interdisciplinary care teams and collaborate with internal and external peers to create holistic care plans addressing medical and non-medical needs.
• Oversee enrollees’ use of long-term services and supports and ensure appropriate systems support remaining in the location of their choice.
• Help members access housing, transportation, food assistance, and other community and social services.
• Educate members about 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.
• Help enrollees pursue preventive health strategies, including gap closure.
• Follow up after hospitalizations or significant health events to support continuity of care and prevent readmissions.
• Coordinate with primary care physicians, specialists, and other healthcare providers and share relevant information.
• Coordinate with community-based organizations, stakeholders, state agencies, and service providers to support coordination and avoid duplication of services.
• Advocate for enrollees’ needs and preferences within the healthcare system.
• Evaluate member satisfaction through communication and monitoring concerns or issues.
• Travel regularly for member, provider, and community-based visits.
• Report suspected abuse, neglect, or exploitation of older adults and adults with disabilities as required by state law.
• Adhere to NCQA and Care Management standards.
• Perform other job-related duties as requested.

Benefits

• Potential eligibility for a bonus tied to company and individual performance.
• A substantial and comprehensive total rewards package is mentioned, but individual benefits are not specified.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree