RN Case Management Lead - Team Growth & Quality

Virginia Premier Health Plan, Inc.; Richmond (VA); On-site; USD 70,000 - 90,000; Full time

Job summary

Virginia Premier Health Plan, Inc. is seeking an experienced leader for case management to supervise team operations and ensure compliance with policies. Responsibilities include managing clinical decisions, training staff, and improving processes.

The ideal candidate will have strong problem-solving skills, knowledge of community resources, and be a licensed Registered Nurse in Virginia. This role requires participation in ongoing education and community programs to address health needs across various age groups.

Qualifications

• Experience in case management in a managed care environment.
• Clinical nursing experience preferable.
• Experience with low income disadvantaged populations.

Responsibilities

• Lead and manage case management staff.
• Ensure compliance with policies and procedures.
• Identify trends for quality improvement.
• Maintain confidentiality of patient information.
• Participate in continuing education activities.

Skills

Problem solving

Patient assessment

Knowledge of community resources

Negotiation skills

Verbal communication

Written communication

Knowledge of ICD-9 and CPT4 coding

Six Sigma Lean methodology

Education

Registered Nurse licensed to practice nursing in Virginia

Job description

Virginia Premier Health Plan, Inc. is seeking an experienced leader for case management to supervise team operations and ensure compliance with policies. Responsibilities include managing clinical decisions, training staff, and improving processes.

The ideal candidate will have strong problem-solving skills, knowledge of community resources, and be a licensed Registered Nurse in Virginia. This role requires participation in ongoing education and community programs to address health needs across various age groups.