Nurse Case Manager II - Virginia

LanceSoft Inc

Richmond, VA

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JOB DETAILS

SALARY

$40–$45 Per Hour

SKILLS

Ambulatory Care, Analysis Skills, Behavioral Health, Case Management, Certified Case Manager (CCM), Clinical Competency, Clinical Data, Clinical Information, Clinical Practices/Protocols, Clinical Study Publications, Coaching, Communication Skills, Compensation and Benefits, Computer Skills, Consulting, Corporate Policies, Cost Control, Crisis Intervention, Diabetes, Documentation, Establish Priorities, Fortune 500 Customers, Healthcare Providers, Healthcare Quality, Home Care, Hospital, Information Technology & Information Systems, Insurance, Maintain Compliance, Managed Care, Multitasking, Needs Assessment, Presentation/Verbal Skills, Problem Solving Skills, Quality Management, Quality of Care, Registered Nurse (RN), Regulations, Regulatory Compliance, Risk Management, Software Development, Team Player, Typing, Writing Skills

LOCATION

Richmond, VA

POSTED

3 days ago

Job Details:
Job Title: ** Nurse Case Manager II **
Job #: {26-78779}
Position Type: {2 Months, Possible extensions}
Location: : (Candidate must reside in Virginia.)
Onsite Flexibility: (This is a travelling position/(Prefer these locations: Arlington, Falls Church, Annandale, Vienna)
Pay Range: ($40.00 to $45.00/Hour on W2)
Schedule: * Work hours: Mon-Fri 8 am -5 pm *

Position Summary:
Description:
Assessment of Members:
• Through the use of clinical tools and information/data review, conducts
comprehensive assessments of referred member’s needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member’s benefit plan and available internal and external programs/services.
• Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and address complex clinical indicators which impact care planning and resolution of member issues.
• Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health or medical crisis and refers them to the appropriate clinical providers for thorough assessment and treatment, as clinically indicated.
• Provides crisis follow up to members to help ensure they are receiving the appropriate treatment/services.

Enhancement of Medical Appropriateness and Quality of Care:
• Application and/or interpretation of applicable criteria and clinical guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or member’s needs to ensure appropriate administration of benefits
• Using holistic approach consults with supervisors, Medical Directors and/or other programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary view in order to achieve optimal outcomes
• Identifies and escalates quality of care issues through established channels
• Ability to speak to medical and behavioral health professionals to influence appropriate member care.
• Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and promotes lifestyle/behavior changes to achieve optimum level of health
• Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
• Helps member actively and knowledgably participate with their provider in healthcare decision-making
• Analyzes all utilization, self-report and clinical data available to consolidate information and begin to identify comprehensive member needs.

Monitoring, Evaluation and Documentation of Care:
• In collaboration with the member and their care team develops and monitors established plans of care to meet the member’s goals
• Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.
• Majority of time is spent on telephonic outreach and documentation in a clinical case management platform.

Experience:
-3 years clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care required.
-Experience preferred managing chronic conditions, such as diabetes, hypertension, and asthma.
-Healthcare and/or managed care industry experience required.
-Case Management experience preferred-- Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding
-Effective communication skills, both verbal and written.
-Ability to multitask, prioritize and effectively adapt to a fast paced changing environment
-Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer.
-Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor.
-Typical office working environment with productivity and quality expectations.
The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy
for options and services to meet an individual’s benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes.

Requires an RN with unrestricted active license in VA or compact license.
RN with current unrestricted state licensure in VA or compact license.

Case Management Certification CCM preferred
Work hours: Mon-Fri 8 am -5 pm

Employee Benefits:
At LanceSoft, full time regular employees who work a minimum of 30 hours a week or more are entitled to the following benefits:
Four options of medical Insurance
Dental and Vision Insurance
401k Contributions
Critical Illness Insurance
Voluntary Permanent Life Insurance
Accident Insurance
Other Employee Perks

You may respond to me via email but please be sure to include your direct phone number so I can reach out to you quickly. In considering candidates for our various positions, time is of the essence, and we are committed to responding to our clients promptly.

Thank you for taking time out of your busy schedule to read and respond to this message.

About LanceSoft:
EEO Employer – Minorities/Females/Disabled/Veterans/Gender Identity/Sexual Orientation
Headquartered in Herndon, Virginia, LanceSoft is one of the fastest growing IT services Company. We are geographically spread to cover all the 50 states in the US and our global software development centers have the capability and capacity to cater to our global client’s requirements in the most efficient manner. We have experienced exponential growth over the last few years and anticipate continuing to do so in the future as well. We have won numerous national, regional, and state awards for being one of the fastest growing companies in the US. Our prestigious client base comprises of a number of Fortune 500 companies. LanceSoft dynamic work environment and culture constantly nurtures innovation, strategic thinking, and creativity and is complemented by strict process controls across our delivery centers globally. With attractive compensation packages, positive and productive work environments, and challenging assignments to offer, LanceSoft is committed to being the employer of choice. We are committed not only to attracting and hiring top talent in the industry, but also developing and maintaining long-term relationships. LanceSoft recognizes true potential and provides people with the right opportunities. We offer a complete range of benefit packages to our employees which includes but is not limited to paid vacations, holidays, personal days, medical, dental and vision insurance, 401K savings plan, life insurance, disability insurance and many other attractive benefits.

About the Company

LanceSoft Inc

We are a $125 Million, NMSDC-certified Minority & Woman owned Workforce Solutions Company headquartered in the DC metro area with presence across US with global presence - Canada, Mexico, India, UK, Malaysia, Indonasia, Hongkong, Singapore, UAE. We are specialized in providing Workforce Solutions, SOW project delivery, Engineering Solutions, Creative Services. We currently support 100+ Fortune companies globally and across multiple industry segments. We are currently supporting several massive programs across industry segment nationally/globally (Intel, Ally, AMD, QUALCOMM, Morgan Stanley, Kraft/ Mondelez, MNP, Amdocs, Dell, SanDisk, Medtronic, Becton Dickinson, GE, Lockheed Martin, UTC, L-3 Communications, Caterpillar, BMW, Mercedes Benz, National Grid, Dominion, Energy Future Holdings, PSEG, 3M, Fidelity, Aetna, Humana, Johnson & Johnson, Pfizer, Merck etc).

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender, identity, national origin, disability, or protected veteran status.

COMPANY SIZE

2,000 to 2,499 employees

INDUSTRY

Staffing/Employment Agencies

FOUNDED

2000

WEBSITE

http://www.lancesoft.com/