Virginia Licensed Case Manager RN

Job Summary

A company is looking for an Integrated Case Manager/Registered Nurse (RN) for the Commercial Complex Cases - Remote in Virginia or North Carolina.

Key Responsibilities

• Develops, monitors, evaluates, and revises member care plans to optimize health care across the continuum
• Performs telephonic clinical assessments and coordinates care for members with complex needs
• Manages chronic illnesses and coordinates care with healthcare teams, ensuring compliance with policies and procedures

Required Qualifications, Training, and Education

• Registered Nurse (RN) License (Compact or Virginia) is required
• Bachelor's Level Degree preferred
• 3 years of Case Management RN experience required
• Experience in Complex Case Integrated Commercial Managed Care preferred
• Proficient with NCQA guidelines