Integrated Care Manager/ Registered Nurse (RN) LTSS Waiver Members/Medicaid - Remote in NOVA (Fairfax, Springfield and Alexandria, VA)
$120,000–$120,000 year
On-siteFairfax, Virginia, United States
Job Summary
Conduct case management services for LTSS Waiver Members and Medicaid enrollees by developing, monitoring, and revising care plans to optimize health across the continuum. Perform telephonic or face-to-face clinical assessments to identify and coordinate physical, behavioral, and social service needs. Manage chronic illnesses and co-morbidities while conducting gap-in-care management and facilitating authorizations or referrals within the benefits structure. Present cases at multidisciplinary conferences and interface with Medical Directors and physician advisors to ensure regulatory compliance. This full-time, permanent role requires a Registered Nurse license and resides in Northern Virginia, with a standard schedule of 8 am to 5 pm EST, M-F.
Required Qualifications
- Registered Nurse (RN) License (Compact or Virginia)
- 3 years experience in Nursing
- Candidate must reside in Northern Virginia (Fairfax, Springfield, and Alexandria, VA), and the surrounding areas
- May travel up to 1 hour max
- Standard working hours: 8 am to 5 pm EST, M-F
- Full-time, permanent position (40 hours)
Desired Qualifications
- Bachelor's Level Degree in Nursing preferred
- Managed Care/ Health Plan/ Health Insurance experience highly preferred
- Case Management experience preferred
- Long-Term Services and Supports (LTSS) waiver and Home Health experience preferred
- Behavioral Health experience is secondary
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