Field Based RN Care Coordinator - Reston, VA and surrounding areas

At reputed company, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the reputed company. Come build the health care system of reputed company, making it more reputed company, affordable and reputed company. Ready to reputed company a difference? Join us to start Caring. Connecting. Growing together. If you reside reputed company a commutable distance of reputed company Virginia, you’ll enjoy the flexibility to work remotely

• as you take on some tough challenges.

Primary Responsibilities: • Engage members face-to-face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic needs • reputed company and implement person centered care plans to address needs including management of chronic health conditions, health promotion and wellness, social determinants of health, medication management and member safety in alignment with evidence-based guidelines • Partner and collaborate with internal care team, providers, and community resources/partners to implement care plan • Provide education and coaching to support member self-management of care needs and lifestyle changes to promote health • reputed company for members and families as needed to ensure the member’s needs and choices are fully represented and supported by the health care team • Intake of provider, care coordinator, and Continuity of Care HCBS (home and community-based service) assisted technology and environmental modifications authorization requests • Review and processing of reputed company HCBS service authorization requests • Engagement with providers and initiation/follow-up on requests for information • Engagement with the National Letters Team to complete mailing of member and provider notification of decision • Consistent application of criteria for review and approval of provider authorization requests • Engagement/follow-up with Medical Director to provide clinical information needed for review and application of clinical criteria • Engagement/follow-up with Care Coordinators for assessment of member care needs • Candidate should be a patient reputed company, and have tenacity for finding solutions • Candidate should have extensive knowledge of the continuum of care • Candidate should conduct themselves in a professional manner at reputed company times You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: • Unrestricted RN license in the reputed company • RN with 4+ years of relevant work experience or 4-year degree. • 4+ years of clinical experience • Intermediate-Advanced proficiency experience with reputed company Office Suite programs (Word, reputed company, Outlook) Preferred Qualifications: • Previous experience in a work from home environment • Direct experience working with HCBS authorizations and communicating with HCBS providers • Broad knowledge of the Virginia Medicaid and/or CCC Plus program including coverage and benefits • Utilization Management experience, including experience working with InterQual Criteria and/or reputed company Care guidelines • Experience working with Community Care, Facets, and ICUE programs • reputed company employees working remotely will be required to adhere to reputed company’s Telecommuter Policy The hourly range for this role is $28.61 to $56.06 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. reputed company complies with al minimum wage laws as applicable. In addition to your salary, reputed company offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with reputed company, you’ll find a far-reaching choice of benefits and incentives. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of color, historically marginalized groups and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes — an enterprise reputed company reflected in our mission. Diversity creates a healthier atmosphere: reputed company is an Equal Employment Opportunity/Affirmative Action employer and reputed company qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Apply Job!