Senior Employer Based Reporting Platform Manager at Cambia overseeing EBR platform governance and strategy. Leading cross - functional initiatives to enhance reporting accuracy and compliance across diverse teams.
About the role
- Integrated Nurse Case Manager managing community health in Petersburg, Dinwiddie, and Chester. Responsible for case management services and collaborating with health care teams.
Responsibilities
- Responsible for case management services within the scope of licensure
- Develops, monitors, evaluates, and revises the member's care plan to meet the member's needs
- Performs telephonic or face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs
- Identifies members for high-risk complications and coordinates care in conjunction with the member and health care team
- Manages chronic illnesses, co-morbidities, and/or disabilities ensuring cost effective and efficient utilization of health benefits
- Assists with the implementation of member care plans by facilitating authorizations/referrals
- Interfaces with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on care management treatment plans
- Presents cases at case conferences for multidisciplinary focus
- Ensures compliance with regulatory, accrediting and company policies and procedures
Requirements
- Associates or Bachelors Degree in Nursing (Required)
- Virginia or Compact RN License (Required)
- 3 years experience in Nursing (Required)
- Experience in Private Duty Nursing or NICU or Experience working with Ventilators (Required)
- Discharge planning experience (Preferred)
- Managed Care experience (Preferred)
Benefits
- Medical, Dental, Vision plans
- Adoption, Fertility and Surrogacy Reimbursement up to $10,000
- Paid Time Off and Sick Leave
- Paid Parental & Family Caregiver Leave
- Emergency Backup Care
- Long-Term, Short-Term Disability, and Critical Illness plans
- Life Insurance
- 401k/403B with Employer Match
- Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education
- Student Debt Pay Down – $10,000
- Reimbursement for certifications and free access to complete CEUs and professional development
- Pet Insurance
- Legal Resources Plan
- Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
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