PT - Case Manager-RN, Mid

Acentra Health; McLean (VA); On-site; USD 45,000 - 55,000; Full time

Benefits offered by this job

Comprehensive health plans

Paid time off

Retirement savings

Educational assistance

Job summary

Acentra Health is hiring an RN Case Manager to evaluate beneficiaries, develop individualized care plans, and coordinate healthcare teams to achieve optimal outcomes while meeting payer requirements. The role emphasizes CMSA principles and ongoing education in a dynamic, technology-enabled environment.

Responsibilities include coordinating care with providers and health plans, maintaining documentation, and pursuing professional development.

Qualifications

• Current, unrestricted RN license in the US
• 3–5 years of RN clinical experience
• BSN and CCM preferred
• Proficiency with Microsoft Word, Excel and Office tools

Responsibilities

• Assess, plan, implement, monitor, and evaluate options to affect an individualized care plan across the continuum of care.
• Utilize clinical knowledge, communication, problem-solving, and conflict resolution to achieve optimal beneficiary outcomes.
• Develop beneficiary-centered care plans.
• Demonstrate shared accountability among beneficiaries, caregivers, and providers.
• Coordinate care with beneficiaries, providers, and Health Plan Care teams.
• Address identified gaps in care or compliance.
• Maintain confidentiality and HIPAA compliance.
• Ensure timely, accurate documentation in the web-based database.
• Pursue ongoing education and stay current with case management standards.

Skills

Communication skills

Team player

Confidentiality

Problem solving

Multitasking

Education

RN license

BSN

CCM

Tools

Microsoft Word

Microsoft Excel

Office Suite

Job description

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes - making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

At Acentra Health, we embrace emerging technologies, including artificial intelligence and advanced analytics that can be utilized to improve processes, enhance decision‑making, and drive better health outcomes. We value professionals who are curious about new technologies and motivated to use innovative tools to increase efficiency, quality, and impact in their roles.

Job Summary

The Case Manager, RN, will evaluate beneficiaries' needs, develop individualized care plans, and coordinates healthcare team members to ensure optimal client outcomes while adhering to payer requirements. They also facilitate integrated case and disease management activities based on CMSA principles, aiming to stabilize beneficiaries' health and avoid long‑term care placement.

Job Responsibilities

• Assess, plan, implement, monitor, and evaluate options and services to affect an appropriate, individualized plan with the beneficiary across the continuum of care.
• Utilize clinical knowledge and competence, communication skills, problem‑solving, and conflict resolution to ensure optimal beneficiary outcomes with consideration to client requirements effectively.
• Develop beneficiary‑centered care plans.
• Demonstrate shared accountability between beneficiaries, caregivers, and providers.
• Work collaboratively with the beneficiary, provider, and Health Plan Care team members to coordinate care.
• Address identified gaps in care or compliance.
• Maintain strict standards for client confidentiality and client‑related information.?
• Comply with all organizational, state, and federal regulations and policies on confidentiality.
• Manage caseload to ensure all required documentation and entry of assessment results into the web‑based database are completed accurately and timely, following regulatory requirements and company policies and procedures.
• Maintain open communication with all appropriate parties.
• Pursue ongoing education, certification, and self‑development to remain current with case management standards.
• Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules

Required Qualifications

• Current, unrestricted Registered Nurse (RN) license in a state or territory of the United States that allows the health professional to independently conduct an assessment as permitted within the scope of practice of the discipline.
• 3 - 5 years RN clinical experience required.

Preferred Qualifications

• BSN and CCM preferred
• Proficiency in using Microsoft Word, Excel, and other applications in the Microsoft Office suite.
• Excellent written and verbal communication skills.
• Ability to work effectively in a team environment.
• Maintain a high level of confidentiality.
• Good problem‑solving skills.
• Ability to maintain metrics and goals within the department.
• Work telephonically, and with computer systems.
• Assist members and conduct outreach to members without prior engagement.
• Flexibility and strong organizational skills.
• Strong understanding of cultural competency when working with the population.
• Experience with Medicaid, Medicare or Commercial health plans.
• Ability to multi‑task and prioritize with variable and sometimes conflicting deadlines; superior attention to detail and demonstrated ability in decision‑making.
• Demonstrated initiative and judgment in the performance of job responsibilities.
• Maintain professionalism, flexibility, and dependability under pressure.
• Strong communication (written/verbal), interpersonal, organizational, time management and communication skills with a strong focus on customer service, including building and maintaining relationships with internal/external customers and facilitating meetings.
• Ability to work independently and as part of a team.
• Ability to research/identify and apply appropriate standards of care.
• Interest in continuous learning and a commitment to staying informed on regulatory changes

Why us?

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.

We do this through our people.

You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.

Benefits

Benefits are a key component of your rewards package. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

EEO AA M/F/Vet/Disability

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.

Experience in Lieu of Degree

For non-clinical roles, or when not required by the contract specifically, the Company acknowledges that practical, hands‑on experience can provide skills and competencies equivalent to formal education. As such, in cases where a Bachelor's degree may be required, the Company will accept a minimum of six (6) years of directly relevant professional experience in lieu of a degree. In instances where the candidate has an Associate's degree, the Company will accept a minimum of three (3) years of directly relevant professional experience in lieu of the Bachelor's degree.

Compensation

The pay for this position is listed below.

$21.63 to $26.44 per hour

Based on our compensation philosophy, an applicant's position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.

Pay Range

USD $67,300.00 - USD $93,050.00 /Yr.