Nurse Case Manager-Northern Virginia/Winchester Region, VA(Arlington, Manassas, Woodbridge, Front Royal, Warrenton)
Sentara Healthcare is currently hiring an Integrated Nurse Case Manager for South West Virginia Region!
This is a Full Time position with day shift hours and great benefits!
Requires travel to conduct face-to-face home visits in the member’s home or other locations within the south west region of VA (Wise county, Lee county, Scott county, Dickenson county, Russel county, Washington county, Bristol) .
Primary responsibilities include:
• Responsible for case management services within the scope of licensure; develops, monitors, evaluates, and revises the member's care plan to meet the member's needs, with the goal of optimizing member health care across the care continuum
• Performs telephonic or face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical and behavioral health, social services and long-term services
• Identifies members for high-risk complications and coordinates care in conjunction with the member and health care team
• Manages chronic illnesses, co-morbidities, and/or disabilities ensuring cost effective and efficient utilization of health benefits; conducts gap in care management for quality programs
• Assists with the implementation of member care plans by facilitating authorizations/referrals within benefits structure or extra-contractual arrangements, as permissible
• Interfaces with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on care management treatment plans
• Presents cases at case conferences for multidisciplinary focus. Ensures compliance with regulatory, accrediting and company policies and procedures
• May assist in problem solving with provider, claims or service issues
Preferred: Private duty nursing experience and knowledgeable with ventilators in a facility or home
Education
• Associates or Bachelors Degree in Nursing
Certification/Licensure
• Registered Nurse License (RN) - Nursing License - Compact/Multi-State License required.
Experience
• 3 years experience in Nursing
• Discharge planning experience preferred
• Managed Care experience preferred
• Preferred: Private duty nursing and knowledgeable with ventilators in a facility or home
Keywords: Care Coordination, Case Management, Human Services, Community Health, Health Education, RN Case Manager, Registered Nurse, BSN, ADN, Private Duty, Ventilator, LinkedIn, Talroo-Nursing
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This is a Full Time position with day shift hours and great benefits!
Requires travel to conduct face-to-face home visits in the member’s home or other locations within the south west region of VA (Wise county, Lee county, Scott county, Dickenson county, Russel county, Washington county, Bristol) .
Primary responsibilities include:
• Responsible for case management services within the scope of licensure; develops, monitors, evaluates, and revises the member's care plan to meet the member's needs, with the goal of optimizing member health care across the care continuum
• Performs telephonic or face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical and behavioral health, social services and long-term services
• Identifies members for high-risk complications and coordinates care in conjunction with the member and health care team
• Manages chronic illnesses, co-morbidities, and/or disabilities ensuring cost effective and efficient utilization of health benefits; conducts gap in care management for quality programs
• Assists with the implementation of member care plans by facilitating authorizations/referrals within benefits structure or extra-contractual arrangements, as permissible
• Interfaces with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on care management treatment plans
• Presents cases at case conferences for multidisciplinary focus. Ensures compliance with regulatory, accrediting and company policies and procedures
• May assist in problem solving with provider, claims or service issues
Preferred: Private duty nursing experience and knowledgeable with ventilators in a facility or home
Education
• Associates or Bachelors Degree in Nursing
Certification/Licensure
• Registered Nurse License (RN) - Nursing License - Compact/Multi-State License required.
Experience
• 3 years experience in Nursing
• Discharge planning experience preferred
• Managed Care experience preferred
• Preferred: Private duty nursing and knowledgeable with ventilators in a facility or home
Keywords: Care Coordination, Case Management, Human Services, Community Health, Health Education, RN Case Manager, Registered Nurse, BSN, ADN, Private Duty, Ventilator, LinkedIn, Talroo-Nursing
Apply tot his job
Apply To this Job