RN Complex Case Manager-Hybrid Lebanon OR Abingdon, Virginia; Counties: Buchanan, Dickinson, Le

Company Overview

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company, to actively engage in problem‑solving, and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes – making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

RN Complex Case Manager – Hybrid

Location:

Lebanon, Oregon or Abingdon, Virginia (Counties: Buchanan, Dickinson, Lee, Russell, Scott, Tazwell, Washington, Wise). This is a full‑time, direct hire, exempt position with benefits.

Job Summary: The RN Complex Case Manager will provide in‑home, in‑person care coordination across defined coal mine states and telephonic care coordination throughout the United States. An integrated case management model assists the Funds team in maintaining beneficiaries at their most optimal functional level.

Responsibilities:

• Provide in‑home, in‑person care coordination in the defined coal mine states and telephonic care coordination across the United States.
• Foster an environment that incorporates the Funds' caring philosophy in all aspects of the case management process and coordinates care with the beneficiary and their provider to stabilize health status with the goal of maximizing functional capacity and improving quality of life.
• Assess, plan, implement, and evaluate options and services to create an individualized plan for the beneficiary across the continuum of care.
• Facilitate, coordinate, integrate, and manage integrated case management and disease management activities based on CMSA definition and guiding principles for case management.
• Use independent nursing judgment and discretion to address, resolve, and process problems impeding diagnostic or treatment progress.
• Seek consultation from physicians, specialists, pharmacists, and other disciplines as necessary to facilitate care for optimal beneficiary function or prevent further decline.
• Develop beneficiary‑centered care plans demonstrating shared accountability between beneficiaries, caregivers, and providers.
• Coordinate health and social services, coach, advocate, educate the beneficiary and family, clarify and assist with physician care plans, and communicate status and plans among the care team.
• Conduct visits in the beneficiary's home and at hospitals, nursing homes, and physicians' offices as necessary.
• Review the care plan and progress in regular care conferences, emphasize transitions to other programs, and teach self‑management and family caregiver management of chronic conditions.
• Ensure day‑to‑day processes comply with URAC and other regulatory standards.

The above list of responsibilities is not intended to be all‑inclusive and may be expanded to include other duties as management deems necessary.

Additional Information:

• Percentage of in‑home, in‑person visits: up to approximately 25%.
• Percentage of telephonic care across multiple time zones: up to approximately 75%.
• Travel to specific counties within Virginia, within a one‑hour drive radius with mileage reimbursement.
• Hours:
  
  8:00 AM – 5:00 PM Eastern Monday‑Friday.

Required Qualifications /

Experience:

• Unrestricted, active RN compact state license.
• High school diploma or GED equivalent.
• 3+ years of clinical experience with 1+ year of case management experience.
• Proficiency in Microsoft Office, Internet/Web navigation, and research.
• Proficiency in electronic medical record systems and navigating multiple computer systems and applications.
• Ability to perform a basic physiological assessment without a physician order.

Preferred Qualifications /

Experience:

• Bachelor of Science in Nursing (BSN) or higher.
• Public Health Nursing experience and geriatric nursing care.
• Certified Case Manager (CCM).
• Ability to multi‑task, prioritize, and…