RN Complex Case Manager (Hybrid within WV counties Marshall, Wetzel)

CNSI and Kepro are now Acentra Health! 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 company’s mission, actively engage in problem-solving, and take ownership of your work daily. Acentra Health offers 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 seeks an RN Complex Case Manager in West Virginia da 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 with the goal of maximizing his/her functional capacity and improving 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 within West Virginia: Marshall and Wetzel. 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 counties within West Virginia: Marshall and Wetzel, 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 as 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.RequirementsRequired Qualifications/Experience:

Unrestricted, active RN license in West Virginia (or compact state license).

High School diploma or GED equivalent.

3+ years of clinical experience with 1+ years of case management experience.

Must be proficient in Microsoft Office, Internet/Web Navigation, and research.

Must be proficient in the use of 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).

Ability to multi-task and prioritize with variable and sometimes conflicting deadlines; superior attention to detail and demonstrated ability in decision-making.

Demonstrated initiative and judgment in performing job responsibilities while maintaining professionalism, flexibility, and dependability under pressure.

Strong communication (written/verbal), interpersonal, organizational, time management, and communication skills with a strong focus on customer service, including building and maintaining relationships with internal/ external customers and facilitating meetings.

Ability to work independently and as part of a team.

Ability to research/identify and apply appropriate standards of care.

Interest in continuous learning and a commitment to staying informed on regulatory changes.

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. Our company cares about our employees, giving 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 interest you. Best of luck in your search! The Acentra Health Talent Acquisition TeamVisit 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.#LI-SD1BenefitsBenefits are a key component of your rewards package. Our benefits are designed to provide additional protection, security, and support for your career and life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more. CompensationThe pay range for this position is $71,000-73,000 annually.“Based on our compensation philosophy, an applicant’s placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.”