Integrated Nurse Case Manager/Registered Nurse/RN for Chronic/Complex Condition in Hampton, Newport News, Yorktown, Williamsburg, VA
$120,000–$120,000 year
HybridHampton, Virginia, United States or Newport News, Virginia, United States
Job Summary
Conduct face-to-face home visits and telephonic clinical assessments for chronic/complex condition members including asthma, diabetes, heart failure, cancer, and COPD. Develop, monitor, and revise care plans to optimize member health across the continuum while identifying high-risk complications and coordinating care with the health care team. Manage chronic illnesses and co-morbidities to ensure cost-effective benefit utilization and facilitate authorizations and referrals within the benefits structure. Present cases at multidisciplinary conferences and interface with Medical Directors and Physician Advisors on treatment plans. Ensure compliance with regulatory policies and assist in problem-solving provider or claims issues. This full-time, 40-hour position requires a Virginia RN license, 3 years of nursing experience, and at least 12 monthly home visits, with applicants residing in Hampton, Newport News, Yorktown, or Williamsburg, VA.
Required Qualifications
- Associate or Bachelors Degree in Nursing
- Registered Nurse (RN) License (Compact or Virginia)
- 3 years experience in Nursing
- Must reside in Hampton, Newport News, Yorktown, Williamsburg, VA, and the surrounding areas
- Must be available for travel to conduct face-to-face home visits (target of at least 12 monthly)
- Must be available for work-from-home position
- Must be available for Standard working hours: 8am to 5pm EST, M-F
- Must be available for Full-time, permanent position (40 hours)
- Must be able to lift 50 lbs
Desired Qualifications
- Case Management experience
- Managed Care or Health Plan experience
- Experience working with chronic/complex condition members (Asthma, diabetes, heart failure, cancer, heart disease, COPD)
- Experience in home health experience, inpatient case management, hospice, transition of care, and discharge planning
- 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
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