Nurse Care Manager, Virginia Medicaid, Falls Church MOB

• In close collaboration with the member/members family, and members of the health care team, assesses the members health status, functional limitations, psychological status, social support systems, resources, environmental factors, and response to treatment.
• Uses motivational interviewing techniques to identify members readiness for change, creates appropriate care plan based on assessments, assists member with health system navigation and connection to community resources.
• Provides supportive counseling and education to members, families and caregivers, members of the health care team, and others including end-of-life issues and Advance Directives.
• Effectively manages and coordinates assigned caseload consistent with established criteria. Ensures consistent and reliable documentation of case management activities in compliance with all organization and department standards.
• Facilitates application process for accessing local, state, and federally funded programs (e.g., Medicaid, Medicare, Disability) and/or refers to appropriate community-based resources.
• Provides education and coaching to improve overall self-management, health, and wellness.
• Monitors chronic health conditions to achieve optimal self-management.

• Minimum two (2) years of experience in case management or three (3) years of clinical experience are required.

• For Virginia Medicaid: Minimum one (1) year of experience working directly with individuals who meet the Cardinal Care Priority Population criteria:

• Individuals involved with Child Protective Services, foster care, and/or former foster youth

• Individuals with Substance Use Disorder

• Youth with a mental health diagnosis

• Minimum one (1) year of experience working directly with individuals who meet the Cardinal Care Priority Population criteria (Individuals with Substance Use Disorder, Youth with a mental health diagnosis, Individuals involved with Child Protective Services, foster care, and/or former foster youth)

• Associates degree in nursing required.

• This job requires credentials from multiple states. Credentials from the primary work state are required at hire. Additional Credentials from the secondary work state(s) are required post hire.
  

• Registered Nurse License (Maryland) within 6 months of hire AND Registered Nurse License (Virginia) within 6 months of hire

OR

• Compact License: Registered Nurse within 6 months of hire

• Registered Nurse License (District of Columbia) within 6 months of hire
  

• Must have reliable transportation and be able to complete in-person assessments in the home and community. (For anyone hired after April 1, 2025).
• Exceptional oral and written communication skills to interact with diverse members and providers and present care plan.
• Exceptional listening skills to assess needs and identify problems.
• Cultural humility to appreciate unique perspectives, backgrounds, and differences.

• Case Manager Certificate (CCM) preferred.
• Pediatrics: Minimum one (1) year of recent experience with pediatric/adolescent population preferred.
• Perinatal: Minimum one (1) year of recent experience with recent labor and delivery of predominately high-risk obstetrics or perinatal population preferred.
• Renal: Minimum one (1) year of recent experience with nephrology or renal population preferred.
• Bachelors preferred.
• Virginia Medicaid requires one year experience working directly with individuals in Cardinal Care Priority populations