Nursing Jobs in Dale City, VA
$89,065 - $162,801 / year
About this Job: General Summary of Position This position will be responsible for the Annual and periodically required Comprehensive Clinical Assessment as cited in section C.3.27.2 of the Department of Health Care Finance awarded contract. The Field RN Case Manager will be responsible for the District of Columbia Region. This position is responsible for up to 85% travel to our MedStar Family Choice District of Columbia Enrollees. The Field RN Case Manager serves as the central point of contact for MedStar Family Choice D.C. Case Management and conducts activities and functions required for this role. The Field RN Manager will be responsible for the referral of MedStar Family Choice Enrollees to other MedStar Family Choice programs as needed i.e. Maternal Health Behavioral Health Food Insecurity relief and Non-Medical Transportation. They are also responsible for the report of Enrollees requiring assistance with Medicare and/or Medicaid beneficiary support Medicaid for Nursing Home Placement Crime Victims Vocational Rehabilitation and any/all other third-party coverage including other available local state and federal programs. Primary Duties and Responsibilities Integrates physical health behavioral health social environmental into a single person-centered seamless system of care. Promotes person-centered approach to service and care planning that honors each Member's priorities goals needs and preferences. Encourages Enrollee engagement in the person-centered service planning process and the use of person-centered planning teams with expertise in community integration behavioral health and health and wellness. Leverages providers community partners and local community resources to ensure comprehensive coordinated and culturally appropriate care for each member. Provides service and support to maintain members in the least restrictive and most appropriate setting as possible. Leverages the use of evidence-based practice guidelines clinical pathways technology solutions and clinical decision support tools. Provides Case Management for designated member population to include support for self-direction nursing home transition transition of care and Utilization Management (UM) activities. Completes field-based member assessments and identifies activities and interventions based on the member needs of this continuum aligning the level of engagement and interventions with identified member needs. Oversees daily weekly and monthly functions of Field Case Manager coordinating member assessments and establishing priorities as needed. This includes the duties clinical analysis documentation and follow up for member clinical reviews and other similar duties to effectively manage the MedStar Family Choice D.C. case managed member population. Prepares and provides reports to manager(s) on work in progress and address any backlogs for resolution. Responsible for informing members about annual required assessments in-person centered service planning processes service alternatives service delivery options e.g. opportunities for self -direction roles rights including MedStar Family Choice D.C Fair Hearing rights risks and responsibilities. Assists with fair hearing requests when needed and requested and to protect the members' health welfare and quality on an ongoing basis. Collects the necessary information including at a minimum: member preferences strengths and goals to inform the development of the person-centered needs and the reevaluation of level of care annually or more frequently as needed. Assists member with person-centered care plans. Works with members to complete activities necessary to maintain MedStar Family Choice D.C. eligibility. Explores coverage of services to address identified member needs through other sources including services provided under medical assistance Medicare or private insurance and other community resources. Actively coordinates with other individuals and entities in the care delivery of member services for physical behavioral and support service needs. MedStar Family Choice DC policies procedures training quality oversight and monitoring for staff and contracted field case managers will ensure consistency in the execution and delivery of our MFC Model of Care. Minimal Qualifications Education Bachelor's degree in Nursing required Experience 1-2 years At least 1 year working in social service or health care related setting required and 1-2 years Experience working with people with Developmental Disabilities HIV Behavioral Health and/or other related vulnerable populations required Licenses and Certifications RN - Registered Nurse - State Licensure and/or Compact State Licensure RN - Registered Nurse - State Licensure and/or Compact State Licensure Upon Hire required Knowledge Skills and Abilities Knowledge of the home and community-based service system and how to access and arrange for services Ability to conduct field-based member assessments up to 85% of the time Experience conducting Department of Health Care Finance needs assessments Cultural competency and the ability to provide informed advocacy Ability to interact with physicians and other health care professionals in a professional manner is required Experience with section C.3.27.2 of the Department of Health Care Finance awarded contract This position has a hiring range of : USD $89,065.00 - USD $162,801.00 /Yr. 
$97,947.20 - $162,801.60 / year
About this Job: General Summary of Position Coordinates activities with the Attending Physician as assigned. The primary responsibilities of the position will be the following: assisting in communications with patients; triaging patients and patient issues symptom management and patient education regarding their disease process and treatment. Assures the monitoring and confirmation of service delivery and evaluation of health care services for patients and patient families. Collaborates with the multi-disciplinary team utilizing clinical outcome data to support innovative and cost-effective changes to practice and to the health care system. These functions are performed in accordance with all applicable laws and regulations of MedStar Georgetown University Hospital's philosophy policies procedures and standards. Primary Duties and Responsibilities Provides direct and indirect care to patients and families and objectively and systematically evaluates the quality and appropriateness of care delivery. Collaborates and coordinates with physicians and all disciplines involved in the patient's care to assure timely progress toward the best clinical outcome in the most cost-effective manner. Provides extensive patient education regarding disease process treatment plan and symptom management. Expertise in specialty area enables the registered nurse to triage and assess patients in order to provide optimum level of care. Assists patients and families through disease process and cancer diagnosis continuum. Collaborates to assist patients with authorizing and precertification of insurance coverage for tests as ordered as part of the treatment plan. Serves to problem solve; focusing on operational issues that may impede patient outcomes in a timely manner Triages phone calls and patient portal inquiries and provides consultations and follow-up as needed. Reports the status of progress and recommends/implements appropriate measures for Performance Improvement (PI). Assists with new employee orientation while continuing to complete competency assessments and continuing education Serves to problem solve; focusing on operational issues that may impede patient outcomes in a timely manner. Performs other duties and responsibilities that are appropriate to the position and area. The above responsibilities are a general description of the level and nature of the work assigned to this classification and is not to be considered as all-inclusive. This position may be used from time to time in other capacities as directed by department leadership Minimal Qualifications Education Bachelor's degree Nursing required Master's degree Nursing preferred Experience 1-2 years relevant clinical experience required 1-2 years ambulatory Care and Oncology experience preferred Licenses and Certifications RN - Registered Nurse - State Licensure and/or Compact State Licensure in the District of Columbia required CPR - Cardiac Pulmonary Resuscitation (includes BLS and NRP) for healthcare providers from either the American Heart Association (AHA) or American Red Cross within 90 Days required Additional unit/specialty certifications may vary by department or business unit. OCN - Oncology Nurse Certification within 1 Year preferred This position has a hiring range of : USD $97,947.20 - USD $162,801.60 /Yr. 
