106444 - Integrated Case Manager - Registered Nurse

Managed Care Services, Inc.; Harrisonburg (VA); Remote; USD 90,000 - 136,000; Full time

Benefits offered by this job

Medical, Dental, Vision plans

401(k)/403(b) with employer match

Paid Time Off

Job summary

Sentara Health in Harrisonburg, VA is seeking an Integrated Case Manager (RN) to coordinate and manage member care across the health system. This remote position requires residency in Harrisonburg or surrounding areas due to travel obligations.

The RN will assess, plan, implement and monitor case management activities, collaborating with a multidisciplinary team to optimize health outcomes while ensuring cost-effective utilization of benefits.

Qualifications

• RN licensure is required.
• 3 years of nursing experience required.
• Managed care experience preferred.
• Discharge planning experience preferred.

Responsibilities

• Perform telephonic or face-to-face clinical assessments to identify, evaluate, coordinate and manage member needs.
• Develop, monitor, evaluate and revise member care plans to optimize health across the continuum.
• Coordinate authorizations/referrals within benefits structure or extra-contractual arrangements.
• Interface with Medical Directors, Physician Advisors and Inter-Disciplinary Teams on care plans.
• Present cases at case conferences for multidisciplinary focus.
• Ensure compliance with regulatory, accrediting and company policies.

Skills

Case management

Communication

Analytical skills

Interpersonal skills

Education

Associates

Bachelor's degree preferred

Tools

RN licensure

Job description

City/StateHarrisonburg, VAWork ShiftFirst (Days)Overview:Sentara Health in Harrisonburg, VA is looking to hire an Integrated Case Manager, RN.This is a remote position; however, candidates must reside in Harrisonburg and surrounding areas as travel is required.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 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. Ensure 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 to include physical, psychological, socio-cultural, spiritual and cognitive needs as well as functional abilities including the need for diversified use of such practices. Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skillsEducation:AssociatesBachelors preferredCertification:Registered Nurse requiredExperience:3 years of nursing experience requiredManaged care preferredDischarge planning experience preferredKeywords: Talroo- Health, Case Management, Managed Care, Discharge PlanningWe provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits. The base pay range for full-time employment is $89,544.00 - $136,468.80 annually. Additional compensation may be available for this role, such as shift differentials, standby/on-call pay, shift premiums, extra-shift incentives, or bonus opportunities. Compensation within the range may vary based on qualifications, experience, location, market conditions, and business needs. Note: If an annual salary is posted, it is based on a full-time colleague working 2,080 hours annually. Sentara offers a comprehensive benefits package, including medical, dental, vision, life and disability insurance; 401(k)/403(b) with employer match; paid time off (vacation, sick time, and holidays); paid parental and military leave; educational assistance or student loan repayment; and voluntary benefits.Benefits: Caring For Your Family and Your Career• 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.Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.In support of our mission “to improve health every day,” this is a tobacco-free environment.For positions that are available as remote work, Sentara Health employs associates in the following states:Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.