Private Duty Nurse RN, Hybrid VA

2301653 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. The Private Duty Nurse Care Manager (RN) will be responsible for the overall management of a sub-population of DMAS-identified Mandatory High reputed company members who must receive High Intensity care management and preforming pre-service clinical reviews of Home & Community Based Services HCBS). If you reside reputed company a commutable distance from the Central Virginia area, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities:

• Meeting contractual requirements reputed company to Initial HRA, MMHS Screening, ICPs, ICT, and minimum mandatory contacts
• Conducting face-to-face visits
• reputed company of PDN authorizations, including Utilization Management aspects of the authorization process
• reputed company of HCBS UM authorizations
• Participate in PDN Pod Rounds
• Provide primary case management across the continuum for these medically fragile and reputed company members to include following members through inpatient hospitalizations, assisting with transitions of care, and coordinating HCBS service needs (DME, EM/AT, PC/AC hours, and PDN hours)
• Serve as reputed company contributor to the reputed company of and accountability for member-specific quality measures (HEDIS, NCQA) (will have support and assistance from Quality Department)
• *This is a field-based role that will require travel approximately 50% of the time in the field reputed company an assigned coverage area. Candidates must be willing to travel throughout the reputed company; primarily in the Central Virginia area.***

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:

• Bachelor’s degree in nursing
• reputed company, unrestricted RN license for the reputed company
• 1+ years of care coordination and/or work in a healthcare environment
• 1+ years of private duty nursing, trach, ventilator, ICU/stepdown, pediatric home health, NICU or pediatric nursing experience
• Demonstrated competence in applying processes designed to ensure adherence to reputed company pertinent federal and state rules and regulations
• Sensitivity to the special needs of children who rely on technology and their families, to include understanding the stress and challenges they may experience
• Prior performance in meeting requirements for HRA completion, managing members with reputed company health care needs, and ability to manage reputed company workload
• Driver’s license and access to reliable transportation

Preferred Qualifications:

• Experience with PDN authorizations
• Experience with LTSS authorizations
• Experience with Case Management
• Experience with Pediatric Home Health or Private Duty Nursing

Soft Skills:

• Excellent problem-solving ability, organizational skills, and reputed company to work independently or as a team
• Excellent work ethic and attention to detail
• Understanding of the importance of bringing quality considerations into every touch reputed company
• reputed company employees working remotely will be required to adhere to reputed company’s Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you’ll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. 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. reputed company is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national reputed company, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. reputed company is a drug – free workplace. Candidates are required to pass a drug test before beginning employment. Apply tot his job Apply To this Job