Managed Care Coordinator-Clinician NonRN

Managed Care Coordinator-Clinician NonRN

Location: Norfolk, VA; Chesapeake, VA; or Richmond, VA. The ideal candidate will reside in Newport News, Hampton, or York County.

Virtual: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.

The Managed Care Coordinator-Clinician NonRN will be working under the direction/supervision of an RN, with overall responsibility for the member's case, as required by applicable state law and contract, and will contribute to the care coordination process by performing activities within the scope of licensure. The role assists the responsible RN with telephonic or face-to-face assessments for the identification, evaluation, coordination and management of the member's needs, including physical health, behavioral health, social services, and community services and supports.

How you will make an impact:

• Assists responsible RN in identifying members for high risk complications.
• Obtains clinical data as directed by the responsible RN.
• Assists the responsible RN in identifying members that would benefit from an alternative level of care or other waiver programs.
• Provides all information collected to the responsible RN, who verifies and interprets the information, conducts additional 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 as directed by responsible RN, and in conjunction with the RN, member and the health care team, to ensure cost effective and efficient utilization of health benefits.
• Applies clinical guidelines and decision making skills based upon the current needs of the member, requiring an understanding of disease processes and terminology, but not requiring 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 applicable state(s) required.

Preferred Skills, Capabilities and Experiences:

• MA/MS in Health/Nursing preferred.
• LPC is also an acceptable licensure.
• May require state-specified certification based on state law and/or contract.
• Travels to worksite and other locations as necessary.

Job Level: Non-Management Non-Exempt

Workshift: 1st Shift (United States of America)

Job Family: MED > Licensed/Certified - Other