Hybrid RN Case Manager – Dual Eligible Special Needs Plan (D-SNP)

at Mass General Brigham

• Job title: RN Case Manager – Dual Eligible Special Needs Plan (D-SNP)
• Job type: Full Time
• Experience level: Junior, Mid level
• Salary: $58,656 - $142,448 per year
• Degree requirement: Associate's Degree
• Location requirements: Hybrid, Somerville, United States

About the role

• RN Case Manager coordinating healthcare services within a clinical setting. Serving dual eligible patients with comprehensive care and treatment planning for improved outcomes.

Responsibilities

• Conduct client assessments and planning.
• Modify patient treatment plans as indicated by patients' responses and conditions.
• Prepare patient/family for discharge.
• Communicate with third party payers to obtain necessary authorization for reimbursement of services.
• Define care goals of patients by providing education, information, and direction to each individual and family.
• Review cases with medical directors on challenging cases as needed.
• Maintain accurate, detailed reports and records.

Requirements

• Associate's Degree Nursing required (Bachelor's Degree Nursing preferred).
• Active and unrestricted Registered Nurse (RN) Licensure for the state of Massachusetts required.
• 2+ years of case management and/or discharge planning required.
• Experience working with complex dually eligible populations required.
• Knowledge of Managed Care preferred.
• Understanding of diagnostic criteria for dual conditions and the ability to conceptualize modalities and placement criteria within the continuum of care preferred.
• Utilization Review experience preferred.

Benefits

• Health insurance
• 401(k) matching
• Flexible working hours
• Paid time off
• Professional development opportunities