[Hiring] Integrated Case Manager- RN @Sentara Health

Role Description

Sentara Health is looking to hire an Integrated Case Manager, RN. This is a remote position; however, candidates must reside in Virginia.

• 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.
• Performs telephonic clinical assessments for the identification, evaluation, coordination, and management of member's needs, including:
  • Physical and behavioral health
  • Social services
  • 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
  • Cognitive needs
  • Functional abilities
• Requires strong oral, written, and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

Qualifications

• Associates degree required; Bachelor's preferred.
• Registered Nurse certification required.

Requirements

• 3 years of nursing experience required.
• Managed care experience preferred.
• Discharge planning 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.
• Reimbursement for certifications and free access to complete CEUs and professional development.
• Pet Insurance.
• Legal Resources Plan.
• Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria are met.