Hybrid RN Case Manager Chicopee
Core
Community-based Registered Nurse providing monitoring, follow-up, and clinical care management to dually-eligible enrollees with complex medical, behavioral, and social care needs.
Role type
Senior IC Registered Nurse Case Manager
Builds
Holistic care plans and care transitions for dual-eligible beneficiaries
Domain
Healthcare / Social Services / Dual-eligible population management
Required skills
Registered Nurse (RN) licensure, care coordination, care plan development, interdisciplinary team leadership, chronic condition management, community resource navigation, Medicare/Medicaid program knowledge, crisis and risk assessment, utilization management, preventative health education, mandatory reporting
Preferred skills
Case Management Certification, prior experience with dual-eligible populations, Medicaid/Medicare managed care experience, clinical field/community-based training
Technologies
Microsoft Office (Outlook, Word, Excel)
Responsibilities
Engage enrollees in homes and community settings to establish care relationships; perform comprehensive, functional, and crisis/risk assessments; lead interdisciplinary care teams to create holistic care plans; oversee utilization of long-term services and supports; assist members in accessing housing, transportation, and social services; educate members on benefits, chronic conditions, and preventive care; follow up after hospitalizations to prevent readmissions; coordinate with providers and community organizations; advocate for enrollee needs; report abuse or neglect as a mandated reporter.
Seniority
Senior, hands-on IC