Care Manager – SNP

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WVU Medicine

WebsiteLinkedInAll Job Openings

10,000+ employees

⚕️ Healthcare Insurance

Healthcare Insurance

WVU Medicine is a comprehensive health system affiliated with West Virginia University, providing medical services through a network of hospitals across West Virginia. The system includes notable facilities such as J. W. Ruby Memorial Hospital, WVU Medicine Children's, and various other regional medical centers. WVU Medicine offers a wide range of healthcare services, including specialized and advanced medical treatments such as robotic heart surgery. It's also involved in medical education, research, and community health initiatives, emphasizing a mission of delivering high-quality care to the communities it serves.

📋 Description

• Providing coordination of care to SNP members, including establishing and maintaining a care plan. • Coordinating care with ICT members and coordinating care during transitions of care. • Acting as a liaison for the Interdisciplinary Care Team (ICT) in conjunction with the PCP and beneficiary/caregiver. • Collaborating with other CM team members to support the beneficiary through TOC events. • Managing and triaging member self-referrals to care management programs. • Assisting in ensuring compliance with CMS SNP Model of Care (MOC) expectations, NCQA standards, and Medicare Advantage regulatory requirements.

🎯 Requirements

• Current Registered Nurse license issued by the state in which services will be provided or current multi-state Registered Nurse license through the enhanced Nurse Licensure Compact (eNLC). • Three (3) years of healthcare clinical experience. • One (1) years Care Management, Case Management or Population Health experience. • Bachelor's Degree in Nursing OR Associate of Science in Nursing Degree (ASN) or Diploma. • Management of Medicare and/or Medicaid and/ or SNP populations. • One (1) year SNP Care Management experience.

🏖️ Benefits

• Health insurance • Competitive salary • Paid time off