[Hiring] Integrated Nurse Case Manager/Registered Nurse (RN) for Maternal Health/ Perinatal @Sentara Health

Role Description

Sentara Health Plans is hiring an Integrated Nurse Case Manager/RN for Maternal Health/Perinatal in Harrisonburg, Staunton, Lexington, Rockingham, Stuarts Draft, Luray, VA, and the surrounding areas!

The position requires both in-person face-to-face assessments and remote telephonic assessments for the low and high risk pregnant population.

Status: Full-time, permanent position (40 hours)

Standard working hours: 8am to 5pm EST, M-F

Location: Applicants must reside in Harrisonburg, Staunton, Lexington, Rockingham, Stuarts Draft, Luray, VA, and the surrounding areas.

• 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 or 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.

Qualifications

• Bachelors Degree in Nursing preferred.
• Registered Nurse (RN) License (Compact or Virginia) REQUIRED.
• 3 years experience in Nursing REQUIRED.
• Case Management experience preferred.
• Managed Care or Health Plan experience preferred.
• Experience working with low and high risk pregnant population preferred.
• Strong knowledge of physical, psychological, socio-cultural, and cognitive patient needs.
• Excellent communication skills, both oral and written, as well as strong problem-solving and analytical skills.

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 is met.