Full Time Insurance Case Manager Jobs in Virginia

DepartmentNURSE CASE MANAGERS - 208415Worker Sub TypeRegularWork Shift

Pay Grade

135Job Description

The Case Manager is responsible for contributing to the development of a goal-directed, age-appropriate plan of care through an interdisciplinary team process that is prioritized and based on determined medical diagnosis, patient needs, and expected patient outcomes. The Case Manager collaborates with the interdisciplinary team to develop and document a discharge plan in the most appropriate setting to meet the patient needs while serving as an advocate to patients and families. The Case Manager ensures that activities to facilitate, broker, and coordinate the plan are being implemented, and that the plan is continuously modified based on the patient's changing needs.
Duties Include:
Negotiating services and resources when deemed needed while using creative problem solving for complex discharge planning.
Active participation in discharge planning rounds and process improvement projects.
Communicating patient needs and updates to appropriate professionals and post-acute providers.
Collaborating with the multidisciplinary team to ensure continued acute hospitalization is appropriate.
Maintaining a supportive and dynamic relationship with all members of the multidisciplinary team as well as post-acute providers.
Completing thorough and timely documentation that accurately reflects the status of the discharge plan.
Completing screens on assigned patients within 24 hours or the first business day.
Serving as a resource and providing education to the multidisciplinary team regarding levels of care, transition planning issues, and regulatory concerns.
Maintaining awareness of research and current trends that influence practice by attending professional meetings, in-services, and conferences.
Maintaining knowledge of reimbursement modalities, community resources, and clinical and legal issues that affect patients and providers of care.
Assists with the arrangement and follow-up with community resources. Case Manager will assist in providing a seamless transition utilizing the entire continuum of care and helping to facilitate patients' movement to the next level of care.

Education

Bachelor's degree in Nursing (BSN) is required.

Master's degree in Nursing (MSN) is preferred.

Graduate of an accredited school of nursing is required.

Experience

Minimum five years of professional practice experience in an acute care setting preferred.

Prior Case Management or Utilization Management preferred.

Certification & Licensure

Licensed as a Registered Nurse in the State of Virginia is required.

BLS Certification (Basic Life Support) - American Heart 'Healthcare Provider' (HCP) - AHA approved is required. New hires must have American Heart Association (AHA) appropriate certification prior to completion of orientation.

Certification in Case Management is desirable.

Qualifications

Skills needed include excellent written/verbal communication and interpersonal skills with all levels of internal and external customers, critical thinking skills, creative problem solving, proficient organization, and planning. Must be self-directed and have the ability to tolerate frequent interruptions and a demanding workload. Knowledge of funding, resources, services, clinical standards, and outcomes is preferred. Demonstrate the ability to be creative, innovative, and flexible in responding to rapidly changing needs and priorities.

Benefits

At Valley Health, we believe everyone is a caregiver, and our goal is to create an environment where our caregivers thrive physically, financially, and emotionally. In addition to a competitive salary, our most popular benefits for full-time employees include:

• A Zero-Deductible Health Plan
• Dental and vision insurance
• Generous Paid Time Off
• Tuition Assistance
• Retirement Savings Match
• A Robust Employee Assistance Program to help with many aspects of emotional wellbeing
• Membership to Healthy U: An Incentive-Based Wellness Program

Valley Health also offers a health savings account & flexible spending account for childcare, life insurance, short-term and long-term disability, and professional development. In addition, several perks come with working for the largest employer in the region, such as discounts to on-campus dining, and more.

To see the full scale of what we offer, visit valleyhealthbenefits.com.