Case Manager II (69920)
 Professional Management Enterprises | |
mileage reimbursement
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 United States, Virginia, Roanoke | |
 Apr 18, 2025 | |
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JOB SUMMARY We are seeking a Case Manager who lives in VIRGINIA (Central, Tidewater, NOVA, Roanoke/Charlottesville). Will work in remote and field settings supporting LTSS (Long Term Services and Support) and the Medicaid Population. Will be required to physically go to member's homes and or Nursing Facilities to complete Face to Face assessments, participate in interdisciplinary care team meetings for our members and ensure members have care plans based on their concerns/health needs. JOB ESSENTIALS Excellent computer skills and attention to detail are very important to multitask between systems, talk with members on the phone, and enter accurate contact notes. This is a fast-paced position and productivity is important. TRAVEL (30% or more) in the field to do member visits to the surrounding areas will be required. Tidewater and Central. This position is eligible for mileage reimbursement. The work schedule is Monday thru Friday 8:00AM to 5:00PM 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, changes in member's health or psychosocial wellness, and triggers from the assessment. * Develops and implements a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals and member's support network. * 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 and supports to enhance the continuity of care for members. * May implement specific wellness programs i.e. asthma and depression disease management. * Facilitates interdisciplinary care team meetings and informal ICT collaboration. * Uses motivational interviewing and clinical guideposts to educate, support and motivate change during member contacts. * 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 If license required for the job, license must be active, unrestricted and in good standing. Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation. Completion of an accredited Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) Program OR Bachelor's or Master's Degree (preferably in a social science, psychology, gerontology, public health or social work or related, Or Graduate from an Accredited School of Nursing. A Bachelor's Degree in Nursing is preferred. | |