Complex Care Manager RN - Tidewater VA Markets

About the role

The Complex Care Manager, RN will be managing complex members and is responsible for facilitating, promoting and advocating for the enrollees' ongoing self-sufficiency and independence. This position is responsible for assessment and planning for an identified group of patients (High risk stratification). Care Manager will manage the care of members in their homes or other community settings by completing telephonic and or face to face health risk assessments and coordinating patient care, focusing on disease management and keeping members healthy and independent. The care manager will provide clinical and medical management services, including care management, health assessments, interventions, and discharge planning. Work is generally self-directed and not prescribed; so, it will be important to function in a less structured work environment.

For consideration you must reside within Tidewater, VA Markets commutable to Williamsburg, Virginia Beach and Norfolk, VA. If you reside within a commutable distance of Williamsburg, VA, you will have the flexibility to work remotely as you take on some tough challenges.

Primary Responsibilities

• Engaging members/families telephonically and/or face to face to coordinate services, community resources, and treatment needs
• Delivering a holistic approach to coordinated care based on the member's needs using a person-centered philosophy
• Identifying early risk factors and conducting ongoing assessments and documenting in an electronic file
• Creating, reviewing and revising care plans and focusing on a holistic approach
• Functioning as an advocate for members
• Collaborating with the members' PCP to deliver and coordinate necessary services
• Building relationships with members and their families; assisting them with coordination of health choices
• Ensuring cases are documented in a timely manner
• Coordination with other state agencies, community resources and providers
• Act as the primary point of contact for Members and the Interdisciplinary Care Team (ICT)

Required Qualifications

• Current, unrestricted RN licensure in the state of Virginia
• 2+ years of recent experience in case management, home care, long term care and/or experience in acute or rehab care setting
• 1+ years of experience directly working with individuals with complex medical or behavioral needs
• Basic level of proficiency in Microsoft Office suite applications (Word, Excel, Outlook/Email, Internet), including the ability to type and talk at the same time and toggle between multiple applications
• Broadband internet capability from home office
• Ability to travel (up to 25%) within a designated geographical region of Virginia for home/site visits
• Access to reliable transportation and valid US driver's license with proof of automobile insurance for vehicle being used

Preferred Qualifications

• CCM certification
• Experience with Medicare and/or Medicaid
• Experience with complex populations
• Managed care/case management experience

Pay

The hourly pay for this role will range from $29 - $52 per hour based on full-time employment.