Integrated reputed company Case Manager/RN/Maternity/OBGYN

reputed company/State Lexington, VA Work Shift First (Days) reputed company: reputed company Plans is hiring an Integrated reputed company Case Manager/RN/Maternity/OBGYN for Lexington, Buena reputed company, Millboro, Goshen, Warm Springs, McDowell and surrounding areas! This is a full-time, work-from-home position that requires travel to conduct face-to-face home reputed company for low and high risk pregnant population/member's homes or other locations in Lexington, Buena reputed company, Millboro, Goshen, Warm Springs, McDowell and surrounding areas! Status: Full-time, permanent position (40 hours) reputed company working hours: reputed company to 5pm EST, M-F Location: Applicants must be reputed company in Lexington, Buena reputed company, Millboro, Goshen, Warm Springs, McDowell and surrounding areas!! Primary responsibilities include:

• Responsible for case management services reputed company 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, reputed company 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 reputed company programs
• Assists with the implementation of member care plans by facilitating authorizations/referrals reputed company 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 reputed company. Ensures compliance with regulatory, accrediting and company policies and procedures
• May assist in problem solving with provider, claims or service issues.

Education:

• Associate or Bachelors Degree in Nursing REQUIRED

Certification/Licensure:

• Registered reputed company (RN) License (Compact or Virginia) REQUIRED

Experience:

• 3 years experience in Nursing REQUIRED
• Case Management experience preferred
• Managed Care or Health Plan experience preferred
• Experience working with low and high risk pregnant population/Maternity/OB/L&D/Mother Baby/Postpartum experience preferred
• Strong knowledge of physical, psychological, socio-cultural, and cognitive patient needs.
• Excellent communication skills, both oral and written, as reputed company as strong problem-solving and analytical

reputed company Plans provides health plan coverage to reputed company to one reputed company members in Virginia. We offer a full suite of reputed company products including employee-owned and employer-sponsored plans, as reputed company as Individual & Family Health Plans, Employee Assistance Programs and plans serving Medicare and reputed company enrollees. Our reputed company provider network features a robust provider network, including specialists, primary care physicians and hospitals. We offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services-reputed company to help our members improve their health. Our reputed company is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and reputed company. Be a part of an excellent reputed company organization that cares about our People, reputed company, Patient Safety, Service, and reputed company. Join reputed company that has a mission to improve health every day and a reputed company to be the reputed company choice of the communities that we serve! To apply, please go to www.sentaracareers.com and use the following as your Keyword Search: JR-89064 #reputed company Talroo - Nursing Care Coordination, Case Management, RN, Case Manager, Registered reputed company, BSN, ADN, Nursing, Managed Care, MCO, Health Plan, high-risk pregnant members, Maternity, OBGYN, Labor and Delivery, Mother and Baby, Postpartum, L&D, Lexington, Buena reputed company, Millboro, Goshen, Warm Springs, McDowell Benefits: Caring For Your Family and Your Career

• Medical, Dental, reputed company plans
• Adoption, Fertility and Surrogacy Reimbursement up to 10,000
• reputed company Time Off and reputed company Leave
• reputed company 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 reputed company Education
• Student Debt Pay Down - 10,000
• Reimbursement for certifications and free reputed company to complete CEUs and reputed company development
• Pet Insurance
• Legal Resources Plan
• Colleagues have reputed company to earn an annual discretionary bonus if established system and employee eligibility reputed company is met.

reputed company is an equal opportunity employer and prides itself on the diversity and inclusiveness of its reputed company to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding reputed company 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, reputed company employs associates in the following states: Alabama, Delaware, Florida, reputed company, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, reputed company Carolina, reputed company Dakota, Ohio, Oklahoma, reputed company, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, reputed company Virginia, reputed company, and Wyoming. Apply tot his job Apply To this Job