RN Complex Case Manager-Hybrid (Counties: Nicholas, Clay, Webster, Braxton, WV)

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact. 

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company, to actively engage in problem-solving, and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes – making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector. 

Acentra is looking for an RN Complex Case Manager - Hybrid (Counties: Nicholas, Clay, Webster, Braxton, West Virginia), to join our growing team.

Job Summary:

• The RN Complex Case Manager will:
• Provide in-home, in-person care coordination in defined areas of coal mine states and telephonic care coordination across the United States. An integrated case management model (including care coordination/case management and disease management) assists the Funds team in maintaining beneficiaries at their most optimal functional level.
• Foster an environment that incorporates the Funds' “caring” philosophy in all aspects of the case management process and coordinates care with the beneficiary and his/her provider to stabilize health status to maximize his/her functional capacity and improve the overall quality of life.
• Responsible for assessing, planning, implementing, and evaluating options and services to create an appropriate, individualized plan for the beneficiary across the continuum of care.
• Facilitate, coordinate, integrate, and manage integrated case management and disease management activities based on the CMSA definition, philosophy, and guiding principles for case management.

PLEASE NOTE:

** This is a full-time, direct hire, exempt, Hybrid opportunity with Benefits.

** The selected candidate is required to reside within a one-hour drive of one of the following Counties: Nicholas, Clay, Webster, Braxton, West Virginia.

** Phone and Travel for In-Home Visits/In-person Care Coordination

• The percentage of In-Home, In-Person Care Coordination visits is up to approximately 25%.
• The percentage of Telephonic Care Delivery across multiple time zones within the U.S. is up to approximately 75%.
• Travel will be to specific cities within Summersville, West Virginia with a drive time distance of up to a one-hour radius maximum (with mileage reimbursement).

** Hours: 8:00 AM – 5:00 PM Eastern Monday-Friday.

** The primary COVID-19 vaccination is required as you will work with beneficiaries in person.

Job Responsibilities:

• Use independent nursing judgment and discretion to address, resolve, and process problems impeding the diagnostic or treatment progress, including medication set-up, blood pressure checks, pulse, temperature, and weight checks to support the home program.
• Seek consultation from physicians, specialists, pharmacists, and other disciplines as necessary to facilitate care to optimize beneficiary function or prevent further decline in health.
• Develop beneficiary-centered care plans demonstrating shared accountability between beneficiaries, caregivers, and providers.
• Coordinate health and social services, coach the beneficiary and families, advocate for the beneficiary, educate the beneficiary and family, clarify, and assist with physician care plans, and communicate status and plans among the care team and resources, as indicated.
• Conduct visits in the beneficiary’s home. Visits to hospitals, nursing homes, and physicians’ offices are necessary to continue the plan of care and support transition.
• Review the care plan and progress in regular care conferences, emphasize transitions to other programs, and teach self-management/family caregiver management of chronic conditions to optimize functions, improve health, prevent further decline, or remain in the community.
• Ensure day-to-day processes are conducted in accordance with the Utilization Review Accreditation Commission (URAC) and other regulatory standards.

The above list of accountabilities is not intended to be all-inclusive. It may be expanded to include other education- and experience-related duties that management may deem necessary from time to time.

Requirements

Required Qualifications/Experience

• Unrestricted, active RN license in West Virginia (or compact state license).
• High School diploma OR GED equivalent.
• 3+ years of clinical experience.
• 1+ years of case management experience.
• Must be proficient in Microsoft Office, Internet/Web Navigation, and research.
• Must be proficient in using electronic medical record systems/electronic documentation and navigating multiple computer systems and applications.
• Maintain competency in basic physiological assessments that do not require a physician order, temperature, pulse, blood pressure, weight, and visual skin assessment.

Preferred Qualifications/Experience:

• Bachelor of Science in Nursing (BSN).
• Public Health Nursing experience and geriatric nursing care.
• Certified Case Manager (CCM).

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Why us? 

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes. 

We do this through our people. 

You will have meaningful work that genuinely improves people's lives nationwide. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career. 

Thank You!

We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search!

~ The Acentra Health Talent Acquisition Team

Visit us at: Acentra.com/Careers

EOE AA M/F/Vet/Disability

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by applicable Federal, State, or Local law.

Benefits

Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.  

Compensation 

The pay range for this position is $71,500-74,000 annually.

“Based on our compensation program, an applicant’s position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.”