Hybrid Registered Nurse Case Manager

Job Title: Hybrid Registered Nurse Case Manager

Location: Remote with some face to face assessments required

Counties needed

1. CHANTILLY
2. HERNDON
3. FAIRFAX

Hours: Monday – Friday 8:00am -5:00pm

Pay: $40.00 - $42.00 per hour

Scheduled Pay: Weekly

Benefits: Health, Dental, Vision, Life Insurance, and Short term disability after 90 days

For more information please contact Ashley Kruger at 586-710-7947 (call /text)

Duties

• They are responsible for assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness.
• Through the use of clinical tools and information/data review, conducts an evaluation of member's needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans.
• Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues.
• Assessments take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality.
• Reviews prior claims to address potential impact on current case management and eligibility.
• Assessments include the member’s level of work capacity and related restrictions/limitations.
• Using a holistic approach assess the need for a referral to clinical resources for assistance in g functionality.
• Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management.
• Utilizes case management processes in compliance with regulatory and company policies and procedures.
• Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.

Experience

• Associates of Science in nursing or Bachelors Degree preferred
• Active Unencumbered Registered state VA license
• Minimum 2 years of RN experience Required
• Home health or Case Management experience highly preferred

For more information please contact Ashley Kruger at 586-710-7947 (call /text)

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