Integrated Case Manager, RN

This is a fully remote position, open to applicants in Virginia.

📋 Description

• Accountable for managing case management services within the parameters of licensure.

• Formulates, monitors, assesses, and updates the care plan for members to address their specific needs.

• Conducts telephonic clinical assessments to identify, evaluate, coordinate, and manage the needs of members.

• Recognizes members at high risk for complications and collaborates with both members and the healthcare team for care coordination.

• Oversees the management of chronic illnesses, co-morbidities, and/or disabilities.

• Supports the execution of member care plans by facilitating necessary authorizations and referrals.

• Engages with Medical Directors, Physician Advisors, and/or Inter-Disciplinary Teams regarding treatment plans in care management.

• Delivers presentations on cases during case conferences to ensure a multidisciplinary approach.

• Guarantees adherence to regulatory, accreditation, and company policies and procedures.

⛳️ Requirements

• A minimum of 3 years of nursing experience is required.

• Must hold a Registered Nurse license.

• Experience in managed care is preferred.

• Prior discharge planning experience is preferred.

• An Associate's or Bachelor's degree is preferred.

🏝️ Benefits

• Comprehensive Medical, Dental, and Vision plans.

• Reimbursement for Adoption, Fertility, and Surrogacy expenses up to $10,000.

• Paid Time Off and Sick Leave provisions.

• Paid Parental & Family Caregiver Leave.

• Emergency Backup Care services.

• Long-Term, Short-Term Disability, and Critical Illness insurance plans.

• Life Insurance coverage.

• 401k/403B plan with Employer Matching contributions.

• Tuition Assistance of $5,250 per year, along with discounted educational opportunities via Guild Education.

• Student Debt Pay Down benefit of $10,000.

• Reimbursement for certifications and complimentary access to complete CEUs and professional development courses.

• Pet Insurance options.

• Legal Resources Plan available.

• Employees may have the chance to earn an annual discretionary bonus, contingent upon meeting established system and employee eligibility criteria.