Hybrid RN Case Manager – D-SNP Care Coordinator

Mass General Brigham Incorporated; Somerville, Northern (MA, KY); Hybrid; USD 59,000 - 142,000; Full time

Job summary

Mass General Brigham Community Physicians, Inc. seeks an RN Case Manager for the Dual Eligible Special Needs Plan (D-SNP).

This hybrid role coordinates care within the clinic and supports enrollment and eligibility needs across MA counties, including Somerville and Plymouth and other sites. You will perform client assessments, plan care, coordinate with third-party payers for authorizations, and partner with families to create a comprehensive plan of healthcare.

Qualifications

• Associate's Degree in Nursing required.
• Active and unrestricted RN licensure for Massachusetts required.
• 2+ years of case management and/or discharge planning required.
• Experience with complex dually eligible populations required.
• Knowledge of Managed Care preferred.
• Understanding diagnostic criteria for dual conditions and placement criteria within the continuum of care preferred.

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.

Skills

Communication skills

Rapport building

Critical thinking

Education

Associate's Degree in Nursing

Bachelor's Degree in Nursing (preferred)

Tools

Microsoft Office

EMR/EHR systems

Job description

Mass General Brigham Community Physicians, Inc. seeks an RN Case Manager for the Dual Eligible Special Needs Plan (D-SNP).

This hybrid role coordinates care within the clinic and supports enrollment and eligibility needs across MA counties, including Somerville and Plymouth and other sites. You will perform client assessments, plan care, coordinate with third-party payers for authorizations, and partner with families to create a comprehensive plan of healthcare.