[Hiring] Integrated Case Manager Registered Nurse @Sentara Health

Role Description

Sentara Health is looking to hire a Remote Integrated Case Manager. Candidates must reside in the State of Virginia.

• The Integrated Case Manager is 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, with the goal of optimizing member health care across the care continuum.
• Performs telephonic and face-to-face clinical assessments for the identification, evaluation, coordination, and management of member's needs, including physical and behavioral health, social services, and long-term services.
• 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.
• Conducts gap in care management for quality programs.
• Assists with the implementation of member care plans by facilitating authorizations/referrals within benefits structure or extra-contractual arrangements, as permissible.
• 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.
• May assist in problem solving with provider, claims, or service issues.
• Demonstrates the minimum knowledge, skills, and abilities to care for the individualized needs of the patient, including physical, psychological, socio-cultural, spiritual, and cognitive needs.
• Requires strong oral, written, and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

Qualifications

• Associates (required)
• BSN (preferred)
• Registered Nurse (required)

Requirements

• 3 years of nursing experience (required)
• Managed care (preferred)
• Disease Management 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
• Pet Insurance
• Legal Resources Plan
• Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.