Sentara
Temp Registered Nurse Medicare Case Manager - Remote (Virginia Only)
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Job Description
- Req#: JR-73993
City/State
Richmond, VAOverview
Work Shift
First (Days) (United States of America)Sentara Health Plan is hiring a Temporary RN Case Management/Care Coordinator for the Medicare Chronic Special Needs Program (C-SNP).
*Estimated 6 month temporary assignment.
Minimum Requirements:
*Valid RN License
*BSN required
*Three years of RN experience required. Acute care experience in a hospital setting, specifically with Pulmonary, Cardiac, and Diabetic patients or previous Medicare Case Management/Care Coordination preferred
*Epic and JIVA EMR experience preferred
*Data entry and Microsoft Excel experience
*Must be available for a start date as soon as possible
The position is remote – work from home is available only in Virginia.
This is a Temporary, 40 hours per week day shift position Mon-Fri between the hours of 8:00am-5:00pm.
Responsibilities:
*RN Clinician 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 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.
Our success 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 healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve!
Keywords: Talroo-Nursing, Monster, LinkedIn, managed care, JIVA, RN, Registered Nurse, Case Management, Care Coordination, referrals, authorizations, Medicare, Hampton Roads, Virginia Beach, Norfolk, Chesapeake, Suffolk, Elizabeth City, Hampton, Portsmouth, heart, lung, diabetes, C-SNP, chronic conditions, ASN, BSN, D-SNP
Job Summary
RN Clinician 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.
Requires an RN; BSN preferred
Demonstrates the minimum knowledge, skills and abilities to care for the individualized needs of the patient to include physical, psychological, socio-cultural, spiritual and cognitive needs as well as functional abilities including the need for diversified use of such practices. Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skillsQualifications:
BLD - Bachelor's Level Degree (Required) Discharge Planning, Managed Care, NursingSkills
Communication, Microsoft Office, Speaking, WritingSentara Healthcare prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
Per Clinical Laboratory Improvement Amendments (CLIA), some clinical environments require proof of education; these regulations are posted at ecfr.gov for further information. In an effort to expedite this verification requirement, we encourage you to upload your diploma or transcript at time of application.
In support of our mission “to improve health every day,” this is a tobacco-free environment.About the company
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