Location: Candidate must reside in Northern Virginia. While primarily remote, occasional travel is required to meet with members face to face.
The Managed Care Coordinator, as required by applicable state law and contract, contributes to the care coordination process by performing activities within the scope of licensure including telephonic or face-to-face assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral health, social services and community services and supports. Position primarily serves individuals with intellectual and/or developmental disabilities.
How you will make an impact:
Assists in identifying members for high risk complications. Obtains clinical data as directed.
Assists in identifying members that would benefit from an alternative level of care or other waiver programs.
Conducts clinical assessments, as necessary, and develops, monitors, evaluates, and revises the member's care plan to meet the member's needs.
Participates in coordinating care for members with chronic illnesses, co-morbidities, and/or disabilities, member and the health care team, to ensure cost effective and efficient utilization of health benefits.
Decision making skills will be based upon the current needs of the member and require an understanding of disease processes and terminology and the application of clinical guidelines but do not require nursing judgment.
Minimum Requirements:
Requires an LPN/LVN, LSW, LCSW, or LMSW or license other than RN in accordance with applicable state law and Nursing Diploma or AS in Nursing or a related field and minimum of 2 years of experience in working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator or similar role; or any combination of education and experience, which would provide an equivalent background.
Current, unrestricted LPN/LVN, LSW, LCSW, LMSW or license other than RN (as allowed by state law) in Virginia required.
Position is primarily telephonic/telehealth but very limited travel or in person work may be required.
Preferred skills, capabilities, and experiences:
Experience with behavioral health and/or working with individuals with intellectual/developmental disabilities strongly preferred.
