FreshRemote.Work

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

Sentara Health Plans Richmond - Remote, United States

City/State

Richmond, 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

We provide market-competitive compensation packages, inclusive of base pay, incentives, benefits, and equity. The base pay rate for Full Time employment is:$66,830.40-$111,384.00

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 if established 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.

Apply

Job Profile

Regions

North America

Countries

United States

Restrictions

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

Benefits/Perks

401k/403b 401k/403b with employer match 401(k) match 403b Annual discretionary bonus Dental Development Disability Emergency backup care Legal resources Life Insurance Medical Paid Time Off Pet Insurance Remote work Sick Leave Student debt pay down Tuition Assistance Vision Vision plans

Tasks
  • Conduct clinical assessments
  • Coordinate care for high-risk members
  • Develop care plans
  • Ensure compliance with policies
  • Monitor and evaluate member needs
Skills

Acute care Behavioral health C Care Coordination Care management Case Management Chronic Illness Management Clinical assessments Compliance Coordination Health Benefits Utilization Health Plan Implementation Interdisciplinary Team Collaboration IT Managed Care Management Medicare Nursing Regulatory Compliance Reimbursement RN RN license Support Telephonic assessments

Experience

3 years

Education

Associates BSN Nursing RN RN-diploma

Certifications

RN RN License

Timezones

America/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9