D-SNP Care Manager, RN

CenCal Health

. Manage a caseload of Dual Eligible Special Needs Plan (D-SNP) members with complex medical, behavioral health, functional, and psychosocial needs .

Posted 9/24/2026full-timeSanta Barbara • California • United StatesMid-LevelSenior💰 $107,053 - $160,580 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing complex medical and behavioral health needs for Dual Eligible Special Needs Plan (D-SNP) members, with a strong focus on care coordination, comprehensive assessments, and regulatory compliance. Proficient in developing and implementing individualized care plans while ensuring effective communication with interdisciplinary teams and stakeholders.

Highest-signal resume keywords

Registered Nurse (RN) LicenseCase Management Certification (CCM, ACM)Complex Case ManagementComprehensive AssessmentsCare Coordination

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Health Risk AssessmentsPerson-Centered Care PlansChronic Disease ManagementDocumentation StandardsCMS and DHCS D-SNP RegulationsAdult Chronic Conditions KnowledgeBehavioral Health Issues Knowledge

Soft Skills

Excellent Verbal CommunicationExcellent Written Communication

Tools & Technologies

Electronic Medical RecordsCare Management PlatformsMicrosoft Office (Word, Excel, Outlook)

Certifications & Qualifications

Registered Nurse (RN) LicenseCase Management Certification (CCM, ACM)

Industry Keywords

Dual Eligible Special Needs Plan (D-SNP)Managed CareTransitions of CareMedicare AdvantageMedi-Cal Regulations

About the role

Key responsibilities & impact

Manage a caseload of Dual Eligible Special Needs Plan (D-SNP) members with complex medical, behavioral health, functional, and psychosocial needs
Conduct comprehensive medical, behavioral, functional, psychosocial, and social-determinants-of-health assessments
Complete timely Health Risk Assessments and triage members according to clinical need and risk
Develop, implement, monitor, and update individualized, person-centered care plans
Coordinate integrated and interdisciplinary care with members, families, caregivers, providers, community organizations, transportation services, and internal departments
Conduct and participate in care conferences, Interdisciplinary Care Team meetings, case reviews, rounds, and case presentations
Address barriers to care, reduce avoidable hospitalizations and emergency-room visits, and promote optimal health outcomes
Educate members and caregivers about benefits, community services, chronic-disease self-management, preventive health, medication adherence, and healthcare resources
Coordinate transitions of care and safe discharges from hospitals, skilled nursing facilities, and other settings
Document assessments, care plans, interventions, interactions, and progress notes accurately and timely
Identify gaps in care and support quality-improvement initiatives, audits, data collection, and regulatory compliance
Protect member confidentiality and comply with HIPAA, privacy regulations, and organizational policies
Serve as a clinical resource and advocate for high-risk members

Requirements

What you’ll need

Candidates must reside on the Central Coast (Ventura, Santa Barbara, San Luis Obispo, Monterey and Santa Cruz Counties) or be willing to relocate upon hire
Current and unrestricted Registered Nurse (RN) license in California
Minimum of 3 years of experience in this nursing role in a managed care setting, hospital, health plan, or equivalent setting
Certification in Case Management (e.g., CCM, ACM) or ability to obtain within two years of employment
Minimum of 3–5 years of clinical nursing experience in acute care, complex case management, care coordination, chronic disease management, transitions of care, or related fields
Experience managing medically complex, high-risk, or vulnerable adult populations
Experience conducting comprehensive assessments and developing person-centered care plans
Knowledge of CMS and DHCS D-SNP regulatory requirements, Model of Care elements, and documentation standards
Strong clinical knowledge of adult chronic conditions, complex co-morbidities, functional and cognitive decline, and behavioral health issues
Proficiency with electronic medical records, care management platforms, Microsoft Office (Word, Excel, Outlook), and internal tracking tools
Excellent verbal and written communication skills
Knowledge of Medicare Advantage and Medi-Cal regulations
Bachelor's degree in Nursing (BSN) preferred
Bilingual or another language in addition to English preferred/stated without a specific required language

Benefits

Comp & perks

Relocation assistance may be available
Certification in Case Management (e.g., CCM, ACM) may be obtained within two years of employment