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

Role Overview

• 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

• comprehensive benefits
• career advancement opportunities
• differentials
• premiums
• bonuses as applicable
• recognition programs designed to celebrate your contributions and support your professional growth