RN Case Manager

Iconma,-Llc.; Virginia (MN); On-site; USD 50,000 - 71,000; Full time

Benefits offered by this job

Health benefits

Referral program

Excellent growth opportunities

Job summary

ICONMA is seeking a RN Case Manager to work onsite in Fairfax County, VA. The role involves coordinating care, leveraging clinical tools, and evaluating member needs against benefit plans in a fast-paced setting.

Requirements include 3 years of clinical practice, healthcare or managed care experience, and an unrestricted VA RN license (compact acceptable). CCM preferred; strong communication and computer literacy are required.

Qualifications

• Proficiency with computer skills and navigating multiple systems.
• Effective verbal and written communication.
• Ability to multitask in a fast-paced environment.
• RN license in VA or a compact license.

Responsibilities

• Assess, plan, facilitate and advocate for benefits and health services to meet member needs.
• Conduct comprehensive assessments to determine benefit plan eligibility.
• Interpret criteria, guidelines and policies to ensure appropriate administration of benefits.
• Apply case management and quality management processes per regulatory standards.

Skills

Communication skills

Multitasking

Adaptability

Time management

Computer literacy

Education

RN license VA or compact

CCM certification preferred

Job description

Up to $44.14 per hour Fairfax County, VA Onsite

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Job Description

Our Client, a Retail Pharmacy, is looking for a RN Case Manager to work in Fairfax County, VA (Arlington, Falls Church, Vienna or Annadale).

Responsibilities:

• Utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual's benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes.
• Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services
• Application and/or interpretation of applicable criteria and guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or member's needs to ensure appropriate administration of benefits
• Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures

Requirements:

• 3 years Clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care required.
• Healthcare and/or managed care industry experience.
• Case Management experience preferred
• Proficiency with computer skills which includes navigating multiple systems and keyboarding
• Effective communication skills, both verbal and written.
• Ability to multitask, prioritize and effectively adapt to a fast-paced changing environment
• Requires an RN with unrestricted active license in the state of VA or a compact license.
• Case Management Certification CCM preferred.

Why Should You Apply?

• Health Benefits
• Referral Program
• Excellent growth and advancement opportunities

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ICONMA is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to any status protected by applicable law. Additional employment notices are available at: Workforce Compliance