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The Position

The Breast and Cervical Cancer Screening Program Medicaid Nurse Case Manager is responsible for assessing clinical eligibility of West Virginia women enrolled in the Breast and Cervical Cancer (BCC) Medicaid Program. Incumbent provides Nurse Case Management services to all women in assigned region who are enrolled in the Medicaid Treatment Act and Breast and Cervical Cancer (BCC Medicaid) These Case Management services include performing a comprehensive needs assessment, educating the patient about disease process and treatment plan options, and assisting the patients in overcoming barriers to treatment by utilizing various community resources. Contact is made with all newly enrolled clients within seven working days of receipt of the BCC Medicaid monthly report. Incumbent contacts treating physicians to obtain current treatment plans and pathology results. The Nurse Case Manager utilizes this clinical information to ensure that current treatment eligibility for the Medicaid Treatment Act is being met. Maintains comprehensive charts containing current treatment status, pathology results and current contacts with patient, physicians, county DHHR offices and other relevant agencies.

Incumbent interprets clinical patient records and accurately enters this clinical data into the Medicaid Treatment Act database per supervisor's guidelines. This information is obtained from the physician, DHHR, patient and other related sources. Responsible for sending out Annual Renewals to existing clients and disenrolling patients who no longer qualify for the program. Meets with the Bureau for Medical Services (BMS) Medical Director on an as needed basis. The Nurse Case Managers alert the Medical Director of patients who may not be eligible for BCC Medicaid. The Nurse Case Managers present the patient specific clinical and treatment information to assist the BMS Medical Director in determining continued eligibility in the BCC Medicaid Program during these review meetings.

Incumbent establishes effective working relationships with clients and healthcare providers to obtain current treatment options. Participates in WVBCCSP meetings and activities as instructed by supervisor and Program Director. Maintains knowledge of WVBCCSP, Diagnostic and Treatment Fund, and the Medicaid Treatment Act. Maintains knowledge of community resources and current treatment for breast and cervical cancer. Perform other duties as assigned by the nursing supervisor.

Minimum Qualifications

Training: Baccalaureate degree in nursing from an accredited four-year college or university and two years of full-time or equivalent part-time paid experience as a registered professional nurse.
OR
Successful completion of an associate degree in nursing from an accredited college or university or a diploma nursing program and three years of experience as a registered professional nurse.
OR
Professional certification from a recognized national nursing certifying organization as a nurse or nurse practitioner in the area of assignment plus two years of full-time or equivalent part-time paid experience as a registered professional nurse.
OR
Successful completion of an associate degree in nursing from an accredited college or university or a diploma nursing program; plus baccalaureate degree in the health sciences or behavioral sciences and two years of full-time or equivalent part-time paid experience in nursing.
OR
Master's degree in nursing from an accredited four-year college or university.

Special Requirement: Current West Virginia license or temporary permit to practice as a registered professional nurse.

Job Type: Full-time

Pay: $38,157.00 - $70,589.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Tuition reimbursement
• Vision insurance

Education:

• Bachelor's (Preferred)

Experience:

• Nursing: 2 years (Preferred)

License/Certification:

• RN (Preferred)

Work Location: In person

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