RN: Case Manager

Job Description

Job Description

Shift Requirements

• Monday to Friday, 8 AM - 5 PM
• On-call schedule: 1 week a month (after hours)

• Virginia License (compact license accepted)

• Mileage reimbursement available

• Counties covered: Patrick, Henry, Pittsylvania, Franklin

• Home health
• HCHB
• Oasis
• Wound care and wound vac
• IV
• Lab draws

• Perform comprehensive assessment of high-risk members.
• Collaborate with primary care providers to ensure the implementation of an individualized, comprehensive care plan with specific interventions designed to engage the member.
• Address, identify, and continuously reassess cost-efficient, appropriate levels of care.
• Put non-medical support in place to ensure compliance with treatment plans (such as housing and transportation).
• Coordinate care transitions as needed.
• Coordinate with physicians, social workers, discharge planners, and claims professionals in transitioning patient to appropriate level of care.
• Engage specialty resources as needed to achieve optimal resolution.
• Keep detailed records of clinical, functional, and fiscal outcomes during the management process.
• Identify opportunities for health promotion and illness prevention.
• Prevent adverse patient occurrences when possible and intervene quickly if prevention is not possible, thereby minimizing poor outcomes.
• Act as patient advocate by protecting privacy and confidentiality issues.

• Associates or Bachelor’s Degree in Nursing or related field.
• Current, unrestricted state Registered Nurse license.
• Ability to analyze complex medical information and make rational decisions.
• Case Management certification.