in United States, Virginia

Start Date: 10/18/2021 End Date: 01/17/2022 Duration: 13 weeks Shift: Days Job Specialty: Cardiology Benefits: Competitive Salaries Generous Per Diem Rates Direct Deposit 401(k) Retirement Plans Job Bonuses Shift Differentials Medical, Dental, and Vision Insurance Free Professional Liability Insurance Licensing Assistance Temporary-To-Permanent Conversion Travel Reimbursement

Start Date: 10/01/2021 End Date: 11/12/2021 Duration: 7 weeks Shift: 5x8 Days Location: Bluefield, VA Benefits: Competitive Salaries Generous Per Diem Rates Direct Deposit 401(k) Retirement Plans Job Bonuses Shift Differentials Medical, Dental, and Vision Insurance Free Professional Liability Insurance Licensing Assistance Temporary-To-Permanent Conversion Travel Reimbursement

This role is work at home following an initial one week of training in Chantilly, VA.25-50% of travel around Northern Virginia is required.Standard business hours Monday-Friday 8am-5pm are required.The Clinical Care Manager utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate physical and behavioral healthcare and social services for members through assessment and member-centered care planning, direct provider coordination/collaboration, and coordination of psychosocial wraparound services to promote effective utilization of available resources, optimal member functioning, and cost-effective outcomes.Nurse Case Manager is responsible for face to face 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. Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration. Services strategies policies and programs are comprised of network management and clinical coverage policies.Please note that this position will require routine and frequent field-based travel to member locations.Preferred Skills:- Case management and discharge planning experience preferred- Managed Care experience preferred- Crisis intervention skills preferred- Knowledge of community resources and provider networks preferred- Familiarity with local health care delivery systems preferred- Behavioral Health experience preferred- Previous experience conducting face-to-face care management is preferred

Nurse Case Manager is responsible for telephonically and/or face to face 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. Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration. Services strategies policies and programs are comprised of network management and clinical coverage policies.This role is work at home following an initial one week of training in Chantilly, VA.25-50% of travel around Northern Virginia is required.Please note that this position will require routine and frequent field-based travel to member locations.Standard business hours Monday-Friday 8am-5pm are required.

Nurse Case Manager is responsible for telephonically and/or face to face 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. Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration. Services strategies policies and programs are comprised of network management and clinical coverage policies.Schedule is Monday-Friday standard business hours.No nights, no weekends and no holidays!Territory is Central region.Travel is 50% local travel within Virginia.

Nurse Case Manager is responsible for telephonically and/or face to face 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. Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration. Services strategies policies and programs are comprised of network management and clinical coverage policies.Territory: Tidewater, Norfolk & Virginia Beach, VA up to 50% local travel around this area.Schedule is Monday-Friday standard business only.No nights, no weekends and no holidays!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 determining 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

Nurse Case Manager is responsible for telephonically and/or face to face 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. Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration. Services strategies policies and programs are comprised of network management and clinical coverage policies.Territory for local travel is Northern Virginia, Winchester, Arlington, and Fairfax.Travel is up to 50%.Schedule is Monday-Friday standard business hours.No nights, no weekends and no holidays!

Nurse Case Manager is responsible for telephonically and/or face to face 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. Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration. Services strategies policies and programs are comprised of network management and clinical coverage policies.Travel is local only.Candidate must be located/residing in: Virginia Beach, Hampton, Tidewater, Chesapeake, Norfolk, Suffolk, & Newport News.Schedule is Monday-Friday standard business, only no nights, no weekends and no holidays!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 determining 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.

Support comprehensive coordination of medical services including Care Team intake, screening and supporting the implementation of care plans to promote effective utilization of healthcare services. Promotes/supports quality effectiveness of Healthcare Services.Responsible for initial review and triage of Care Team tasks.Identifies principle reason for admission, facility, and member product to correctly apply intervention assessment tools.Screens patients using targeted intervention business rules and processes to identify needed medical services, make appropriate referrals to medical services staff and coordinate the required services in accordance with the benefit plan.Monitors non-targeted cases for entry of appropriate discharge date and disposition.Identifies and refers outlier cases (e.g., Length of Stay) to clinical staffIdentifies triggers for referral into Aetna's Case Management, Disease Management, Mixed Services, and other Specialty Programs. Utilizes eTUMS and other Aetna systems to build, research and enter member information, as needed.Support the Development and Implementation of Care Plans.Coordinates and arranges for health care service delivery under the direction of nurse or medical director in the most appropriate setting at the most appropriate expense by identifying opportunities for the patient to utilize participating providers and servicesPromotes communication, both internally and externally to enhance effectiveness of medical management services (e.g.,health care providers, and health care team members respectively)Performs non-medical research pertinent to the establishment, maintenance and closure of open casesProvides support services to team members by answering telephone calls, taking messages, researching information and assisting in solving problems.

Nurse Case Manager is responsible for telephonically and/or face to face 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. Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration. Services strategies policies and programs are comprised of network management and clinical coverage policies.Background Experience- Case Management in an integrated model preferred 5 years clinical practice experience- Experience in the following: psychiatric nursing, working with homeless, severe mental illness, or people who have strong needs for social resources