Clinical Care Manager

Title: Clinical Care Manager

Location: Massachusetts (community based)

Schedule: Monday - Friday 8am - 5pm

Interview process: One virtual round interview

Duration: Through the end of the year

Compensation: $45 - $53 (depending on years of experience)





Must haves


- Current Massachusetts license as one of the following:
- Registered Nurse (RN)
- Licensed Clinical Social Worker (LCSW/LICSW)
- Licensed Mental Health Counselor (LMHC)
- Associate's Degree in Nursing or Master's Degree in Social Work/Mental Health Counseling
- Either:
- 3+ years of RN/Behavioral Health Clinician experience, or
- 1 year of RN/Behavioral Health experience plus 2 years working with complex populations
- Valid driver's license, reliable transportation, and auto insurance






Pluses


- LTSS and Dual-Eligible populations
- Medicare/Medicaid managed care
- Population health or community health
- Behavioral health
- Complex care coordination
- Case Management Certification (CCM) preferred






Day-to-Day Responsibilities

This community-based Care Manager supports dual-eligible Medicare and Medicaid members with complex medical, behavioral, and social needs. The primary focus is conducting assessments, developing member-centered care plans, and coordinating services to improve health outcomes and quality of life.



Responsibilities include:


- Conducting in-home and community-based member visits
- Completing comprehensive assessments and/or UCA Assessments
- UCA = Uniform Core Assessment
- UCA used to be referred to as an MDS assessment
- Developing and managing individualized care plans
- Coordinating care across providers, hospitals, community organizations, and state agencies
- Assisting members with housing, transportation, food assistance, and other social services
- Educating members on benefits, chronic disease management, preventive care, and wellness
- Following up after hospitalizations and significant health events to reduce readmissions
- Ensuring compliance with NCQA and Care Management standards








Compensation

$45 to $53

Exact compensation may vary based on several factors, including skills, experience, and education.

Benefit packages for this role will start on the 31st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.