West Virginia Senior Advantage, a division of CommuniCare Family of Companies is recruiting for an RN Case Manager with Medicare Advantage experience. This position will cover the Central West Virginia region.

The position of Case Manager is part of Healthcare Services and reports to the Market Lead. The Case Manager position will have strong working relationships with the Chief Medical Officer and other key contributors across the enterprise. The Case Manager will have experience in working with institutional skilled nursing populations. 

QUALIFICATIONS & EXPERIENCE REQUIREMENTS

• Licensed Registered Nurse (RN) with both physical and behavioral health case management experience in an integrated setting preferred.
• Minimum of 3-5 years’ in Case Management preferred.
• Experience in Medicare Advantage programs preferred.
• Experience in Health Coaching, Diabetes Management or Cardiac Disease Management, or with older adults or people with disabilities a bonus.
• Must have reliable transportation to enable face to face visits with members.
• Ability and experience utilizing a variety of applications and databases to fulfill care management requirements, documentation.

KNOWLEDGE/SKILLS/ABILITIES

• Must have integrity and a strong ethical compass.
• Strong planning and organizational and time management skills with the ability to work independently.
• Must be excited by the opportunity to work within an integrated delivery system. 
• Must have strong communication skills and the ability to work effectively with people coming from diverse cultural and professional perspectives.
• Knowledge of current models or standards of case management.
• Excellent interpersonal, written, and organizational skills required.
• Must be a proactive and effective, creative problem-solver.

JOB DUTIES & RESPONSIBILITIES

• Acts as generalist with both strong physical and behavioral health case management knowledge.
• Act a resource for community programs including behavioral health services, approaches in working with complex members.
• Telephonically manage or provide support to other case management staff, including PHP, for members that travel outside the service areas
• Acts as a Subject Matter Expert (SME) for other case managers including nurse practitioners at PHP.
• Responsible for facilitating the Models of Care for assigned members including but not limited to the Health Risk Assessment (HRA), Interdisciplinary Care Team (ICT), Interdisciplinary Care Plan (ICP), care transitions, and advanced care planning.
• Implements the Case Management Program for their assigned members.
• Maintain knowledge of Medicare benefits, Plan benefit plans, extra benefits, case management, and utilization management procedures, community resources, principles of self-determination, and patient-centered care.

Benefits

As a CommuniCare employee you will enjoy competitive wages and PTO plans. We offer full time employees a menu of benefit options from life and disability plans to medical, dental, and vision coverage from quality benefit carriers. We also offer 401(k) with employer match and Flexible Spending Accounts.

About Us

A family-owned company, we have grown to become one of the nation’s largest providers of post-acute care, which includes skilled nursing rehabilitation centers, long-term care centers, assisted living communities, independent rehabilitation centers, and long-term acute care hospitals (LTACH). Since 1984, we have provided superior, comprehensive management services for the development and management of adult living communities. We have a single job description at CommuniCare, "to reach out with our hearts and touch the hearts of others." Through this effort we create "Caring Communities" where staff, residents, clients, and family members care for and about one another.