Integrated Nurse Case Manager/Registered Nurse/RN for Chronic/Complex Condition in Hampton, Newport News, Yorktown, Williamsburg, VA
Core
Full-time nurse case manager providing telephonic and face-to-face home visits to optimize healthcare for members with chronic/complex conditions (asthma, diabetes, heart failure, cancer, heart disease, COPD) across the care continuum.
Role type
Senior IC nurse case manager (chronic/complex conditions)
Builds
Integrated care plans and coordinated services for high-risk members
Domain
Healthcare / Managed Care / Chronic Disease Management
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Case management, clinical assessment, care plan development, care coordination, gap in care management, benefits structure navigation, multidisciplinary team collaboration, regulatory compliance
Preferred skills
Managed care or health plan experience, home health experience, inpatient case management, hospice experience, transition of care and discharge planning, knowledge of physical/psychological/socio-cultural patient needs
Technologies
None stated
Responsibilities
Develop, monitor, evaluate, and revise member care plans; perform telephonic or face-to-face clinical assessments; identify members for high-risk complications; manage chronic illnesses and co-morbidities; facilitate authorizations/referrals; interface with Medical Directors and Inter-Disciplinary Teams; present cases at case conferences
Seniority
Mid-level, hands-on IC