Our Client, a Retail Pharmacy, is looking for a RN Case Manager for their Nova, VA location. They are also open to candidates located in any of these locations: Sterling, Reston, Chantilly, Oakton or Herndon. Responsibilities:
+ Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services
+ Application and/or interpretation of applicable criteria and guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or member’s needs to ensure appropriate
+ administration of benefits
+ Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures
Requirement...