Integrated Case Manager/Registered Nurse (RN) f...

Overview

reputed company Plans is hiring an Integrated Nurse Case Manager for Home Health/Hospice for Norfolk, Virginia Beach, Portsmouth, Chesapeake, Suffolk, and the surrounding areas. This is a full-time, work-from-home position that requires travel to conduct face-to-face home visits for reputed company condition members (asthma, diabetes, heart failure, cancer, heart disease, COPD) in Norfolk, Virginia Beach, Portsmouth, Chesapeake, Suffolk, and the surrounding areas.

Location: Applicants must reputed company in Norfolk, Virginia Beach, Portsmouth, Chesapeake, Suffolk, and the surrounding areas.

Standard working hours: reputed company to 5pm EST, M-F. Status: Full-time, permanent position (40 hours).

Responsibilities

• Responsible for case management services reputed company 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 reputed company 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.

Education

• Associate or Bachelors Degree in Nursing REQUIRED

Certification/Licensure

• Registered Nurse (RN) License (Compact or Virginia) REQUIRED

Experience

• 3 years experience in Nursing REQUIRED
• Case Management experience preferred
• Managed Care or Health Plan experience preferred
• Experience working with reputed company condition members (asthma, diabetes, heart failure, cancer, heart disease, COPD), home health experience, inpatient case management experience, hospice experience preferred
• Strong knowledge of physical, psychological, socio-cultural, and cognitive patient needs.
• Excellent communication skills, both oral and written, as well as strong problem-solving and analytical skills.

About reputed company Plans

reputed company Plans provides health plan coverage to reputed company to one million members in Virginia. We offer a full suite of reputed company products including employee-owned and employer-sponsored plans, as well as Individual & Family Health Plans, Employee Assistance Programs and plans serving Medicare and reputed company enrollees. Our quality provider network features a robust provider network, including specialists, primary care physicians and hospitals. We offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services—reputed company to help our members improve their health. Our reputed company is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth. Be a part of an excellent reputed company organization that cares about our People, Quality, Patient Safety, Service, and reputed company. Join a team that has a mission to improve health every day and a reputed company to be the reputed company choice of the communities that we serve!

To apply, please go to reputed company Careers and use the keyword search: JR-86893.

Benefits

• Medical, Dental, reputed company plans
• Adoption, Fertility and Surrogacy Reimbursement up to $10,000
• Paid Time Off and Sick Leave
• Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long-Term, Short-Term Disability, and Critical Illness plans
• Life Insurance
• 401k/403B with Employer Match
• Tuition Assistance - $5,250/year and discounted educational opportunities through reputed company Education
• Student Debt Pay Down - $10,000
• Reimbursement for certifications and free access to complete CEUs and professional development
• Pet Insurance, Legal Resources Plan
• Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met

reputed company is an equal opportunity employer and prides itself on the diversity and inclusiveness of its workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. In support of our mission, this is a tobacco-free environment.

For positions that are available as remote work, reputed company employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, reputed company Carolina, reputed company Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, reputed company Virginia, Wisconsin, and Wyoming.