Hybrid RN Care Manager -Springfield-$5k SIGN ON BONUS

Job description

Hybrid RN Care Manager -Springfield-$5k SIGN ON BONUS

nApply (

nremote type

nMobile

nlocations

nBoston, MA

nSpringfield, MA

ntime type

nFull time

nposted on

nPosted 2 Days Ago

njob requisition id

nR13181

nJob Summary:

nThe Integrated Care Clinical Manager - Massachusetts at CareSource/Commonwealth Care Alliance (CCA) is a community based registered nurse responsible for providing monitoring, follow-up and clinical care management to dually-eligible enrollees with complex medical, behavioral and social care needs. This position focuses on integrating health services and community resources to coordinate enrollee care for improve health outcomes and enhanced quality of life.

nEssential Functions:

nnnEngage with the enrollee in their homes and other community settings to establish an effective, complex care management relationship, while considering the cultural and linguistic needs of each member.

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nnFunction as a liaison between healthcare providers, community resources, and enrollees to ensure seamless communication and care transitions.

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nnPerform required assessments on a timely basis, including but not limited to Comprehensive Assessment, MDS-HC (or successor) Functional Assessments, and Crisis and Risk Assessments

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nnEngage enrollees in care plan development and implementation, providing routine updates as the enrollee’s status changes

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nnLead the interdisciplinary care team (ICT) and collaborate with peers both internal and external to the organization, to create holistic care plans that address medical and non-medical needs.

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nnOversee enrollee utilization of long-term services and supports, ensuring appropriate systems are in place for enrollees to remain in the location of their choice

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nnAssist members in accessing community resources, including housing, transportation, food assistance, and social services.

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nnEducate members about their benefits and available services under both Medicare and Medicaid.

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nnProvide education to members and their families about managing chronic conditions, medication adherence, and preventive care.

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nnPromote healthy lifestyle choices and self-management strategies.

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nnAssist enrollees in preventative health strategies, including gap closure

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nnFollow up with members after hospitalizations or significant health events to ensure continuity of care and prevent readmissions.

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nnWork closely with primary care physicians, specialists, and other healthcare providers to coordinate care and share relevant information.

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nnCoordinate with community-based organizations, other stakeholders/entities, state agencies, and other service providers to ensure coordination and avoid duplication of services.

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nnAdvocate for the needs and preferences of enrollees within the healthcare system.

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nnEvaluate member satisfaction through open communication and monitoring of concerns or issues.

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nnRegular travel to conduct member, provider and community-based visits as required

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nnReport abuse, neglect, or exploitation of older adults and adults with disabilities as a mandated reporter as required by State law.

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nnAdherence to NCQA and Care Management standards

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nnPerform any other job related duties as requested.

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n nEducation and Experience:

nnnAssociates of Science (A.S) degree in nursing from an accredited nursing program required

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nnA Registered Nurse with the ability to independently serve people with complex medical, behavioral, and social needs.​ required

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nnPrior experience in care coordination, case management, or working with dual-eligible populations preferred

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nnMedicaid and/or Medicare managed care experience preferred

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nnClinical Field/ Community Based Training a Plus

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n nCompetencies, Knowledge and Skills:

nnnIntermediate proficiency level with Microsoft Office, including Outlook, Word and Excel.

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nnUnderstanding of Medicare and Medicaid programs, as well community resources and services available to dual-eligible beneficiaries.

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nnStrong interpersonal and communication skills to effectively engage with members, families, and healthcare providers

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nnAbility to manage multiple cases and priorities while maintaining attention to detail.

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nnAdhere to code of ethics that aligns with professional practice.

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nnAwareness of and sensitivity to the diverse backgrounds and needs of the populations served

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nnDecision making and problem-solving skills.

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nnAbility to function independently and effectively as part of an interdisciplinary team

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nnStrong and effective communication skills, both written and verbal

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nnStrong interpersonal and customer relations skills

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nnStrong customer service skills

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n nLicensure and Certification:

nnnCurrent unrestricted clinical license in the Commonwealth of Massachusetts as a Registered Nurse (RN) required

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nnCase Management Certification is highly preferred

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nnMust have valid driver's license, vehicle and verifiable insurance. Employment in this position is conditional pending successful clearance of a driver’s license record check. If the driver’s license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in this position will be terminated

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nnTo help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 – March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified.

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nnCareSource adheres to all federal, state, and local regulations. CareSource 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. Request for accommodations will be completed through an interactive review process.

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n nWorking Conditions:

nnnThis is a mobile position, meaning that regular travel to different work locations, including homes, offices or other public settings, is essential. Will be exposed to weather conditions typical of the location and may be required to stand and/or sit for long periods of time. Must reside in the same territory they are assigned to work in; exceptions may be considered, due to business need May be required to travel greater than 50% of time to perform work duties. Required to use general office equipment, such as a telephone, photocopier, fax machine, and computer Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our members

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nnMust live within commutable distance to the Commonwealth of Massachusetts

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nnOver 50% (Mobile) Routine travel required

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n nCompensation Range:

n$80,000 - $120,000

nCareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

nCompensation Type (hourly/salary):

nSalary

nOrganization Level Competencies

nnnFostering a Collaborative Workplace Culture

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nnCultivate Partnerships

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nnDevelop Self and Others

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nnDrive Execution

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nnInfluence Others

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nnPursue Personal Excellence

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nnUnderstand the Business

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n nThis job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

n#LI-CD1

nBrand=Commonwealth Care Alliance

nAbout Us

nThe CareSource mission is known as our heartbeat. Just as we support our members to be the best version of themselves, our employees are driven by our mission to create a better world for members, stakeholders and providers.

nWe are difference-makers who combine compassionate hearts with our unique business expertise to make every opportunity count. Each claim, each phone call, each consumer-centric decision is a chance to change the world for one member, and our employees look for ways to do that every day.

nThe challenge is, there is no one right way to be the difference and we’re looking for people like you that will rewrite that definition every day. We do what it takes to form creative solutions that make our community and the world just a little better. Discover what it means to be #UniquelyCareSource.

Worksite address

springfield, MA, 01119, US

Who can apply

Review the original listing for work authorization, qualifications and employer requirements.