Case Manager II (66167)
 Professional Management Enterprises | |
 United States, Virginia, Virginia Beach | |
 Jan 15, 2025 | |
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Case Manager IIworks with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care for members with high need potential. Qualified candidatesMUSTlive in Central VIRGINIA. TRAVEL (30% or more) is required to conduct field visits in the surrounding areas supporting our Medicaid population. The work schedule is M-F, 8am-5pm EST - No weekends. KNOWLEDGE/SKILLS/ABILITIES * Completes clinical assessments of members per regulated timelines and determines who may qualify for case management based on clinical judgment. * Develops and implements a case management plan in collaboration with the member, care team and member's support network to address the member needs and goals. * Conducts telephonic, face-to-face or home visits as required. * Performs ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. * Maintains ongoing member case load for regular outreach and management. * Promotes integration of services for members including behavioral health care and long term services. * May implement specific wellness programs i.e. asthma and depression disease management. * Facilitates interdisciplinary care team meetings and informal ICT collaboration. * Assesses for barriers to care, provides care coordination and assistance to member to address concerns. * Collaborates with RN case managers/supervisors as needed or required * Case managers in Behavioral Health and Social Science fields may provide consultation, resources and recommendations to peers as needed Required Years of Experience:1-3 years in case management, disease management, managed care or medical or behavioral health settings. Required Licensure / Education:Active, unrestricted RN State license in good standing. Graduate from an Accredited School of Nursing. Bachelor's Degree in Nursing preferred. Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation. | |