Temp Registered Nurse Medicare Case Manager - Remote (Virginia Only)

Sentara; Woodbridge (VA); Remote; USD 80,000 - 100,000; Full time

Job summary

An established industry player is seeking a Temporary RN Case Management/Care Coordinator for a dynamic role in the Medicare Chronic Special Needs Program. This position offers a unique opportunity to work remotely within Virginia, providing essential case management services and optimizing health care for members. You will be responsible for conducting clinical assessments, managing chronic illnesses, and collaborating with healthcare teams to ensure comprehensive care. Join a forward-thinking organization that values diversity and inclusiveness while making a meaningful impact on community health.

Benefits

Medical, Dental, Vision plans

Adoption, Fertility and Surrogacy Reimbursement up to $10,000

Paid Time Off and Sick Leave

Paid Parental & Family Caregiver Leave

Emergency Backup Care

Long-Term, Short-Term Disability, and Critical Illness plans

Life Insurance

401k/403B with Employer Match

Tuition Assistance - $5,250/year

Student Debt Pay Down - $10,000

Qualifications

• Three years of RN experience required, preferably with Medicare Case Management.
• Acute care experience with Pulmonary, Cardiac, and Diabetic patients preferred.

Responsibilities

• Develop and monitor care plans to optimize member health care.
• Perform clinical assessments and coordinate care for members.

Skills

Case Management

Care Coordination

Telephonic Assessments

Chronic Illness Management

Regulatory Compliance

Education

RN Diploma

BSN

Job description

City/State

Williamsburg, VA

Work Shift

First (Days)

Overview:

Sentara Health Plan is hiring a Temporary RN Case Management/Care Coordinator for the Medicare Chronic Special Needs Program (C-SNP).

*Estimated 6 month temporary assignment.

This is a Temporary, 40 hours per week day shift position Mon-Fri between the hours of 8:00am-5:00pm.

The position is remote - work from home is available only in Virginia.

Temporary positions do not offer benefits and the pay rate is firm at $47.25/hr.

RN Clinician responsible for case management services within the scope of licensure; develops, monitors, evaluates, and revises the member's care plan to meet the member's needs, with the goal of optimizing member health care across the care continuum. Performs telephonic or face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical and behavioral health, social services and long-term services. Identifies members for high-risk complications and coordinates care in conjunction with the member and health care team. Manages chronic illnesses, co-morbidities, and/or disabilities ensuring cost effective and efficient utilization of health benefits; conducts gap in care management for quality programs. Assists with the implementation of member care plans by facilitating authorizations/referrals within benefits structure or extra-contractual arrangements, as permissible. Interfaces with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on care management treatment plans. Presents cases at case conferences for multidisciplinary focus. Ensures compliance with regulatory, accrediting and company policies and procedures. May assist in problem solving with provider, claims or service issues.

Education

• RN Diploma
• BSN preferred

Certification/Licensure

• RN License (Required)

Experience

• Three years of RN experience required.
• Acute care experience in a hospital setting, specifically with Pulmonary, Cardiac, and Diabetic patients or previous Medicare Case Management/Care Coordination preferred.

Keywords: Talroo-Nursing, Monster, LinkedIn, managed care, JIVA, RN, Registered Nurse, Case Management, Care Coordination, referrals, authorizations, Medicare, Hampton Roads, Virginia Beach, Norfolk, Chesapeake, Suffolk, Elizabeth City, Hampton, Portsmouth, heart, lung, diabetes, C-SNP, chronic conditions, ASN, BSN, D-SNP

Benefits: Caring For Your Family and Your Career

* Medical, Dental, Vision plans

* Adoption, Fertility and Surrogacy Reimbursement up to $10,000

* Paid Time Off and Sick Leave

* Paid Parental & Family Caregiver Leave

* Emergency Backup Care

* Long-Term, Short-Term Disability, and Critical Illness plans

* Life Insurance

* 401k/403B with Employer Match

* Tuition Assistance - $5,250/year and discounted educational opportunities through Guild Education

* Student Debt Pay Down - $10,000

* Reimbursement for certifications and free access to complete CEUs and professional development

*Pet Insurance
*Legal Resources Plan
*Colleagues have the opportunity to earn an annual discretionary bonus ifestablished system and employee eligibility criteria is met.

Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.

In support of our mission "to improve health every day," this is a tobacco-free environment.

For positions that are available as remote work,Sentara Health employs associates in the following states:

Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.