Integrated Care Manager- Eastern Shore

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

Benefits offered by this job

Medical, dental, and vision plans

Life and disability insurance

401(k) with employer match

Paid time off

Job summary

Sentara Health is seeking an Integrated Case Manager, RN to support members across the Eastern Shore region. This remote role requires residing on Virginia's Eastern Shore or nearby, with 50%–75% travel for in-home and community visits.

You will assess, plan, and coordinate care for members with behavioral health needs, waiver services, and complex care management, collaborating with interdisciplinary teams to improve health outcomes and independence.

Qualifications

• Active RN license is required.
• Associate Degree in Nursing is required; BSN preferred.
• Minimum of three years of clinical nursing experience; care management/waiver experience preferred.

Responsibilities

• Perform comprehensive assessments of members with complex needs.
• Manage caseload of waiver and behavioral health patients.
• Develop and maintain individualized care plans across physical and behavioral health and LTSS.
• Coordinate care with providers, caregivers, and interdisciplinary teams.
• Identify at-risk members and implement interventions to reduce hospitalizations.

Skills

RN licensure

Case management

Assessments

Education

Associate Degree in Nursing

Bachelor's Degree in Nursing (BSN)

Job description

City/StateNewport News, VAWork ShiftFirst (Days)Overview:Sentara Health is hiring an Integrated Case Manager, RN to support members across the Eastern Shore region, with a primary focus on Behavioral Health, Waiver Services, and Complex Care Management.This is a remote position; however, candidates must reside on Virginia's Eastern Shore or within a reasonable commuting distance. Regular travel throughout the Eastern Shore is required to conduct in-home and community-based member visits. Travel may comprise approximately 50% to 75% of the workweek.Position OverviewThe Integrated Case Manager, RN is responsible for providing comprehensive case management services within the scope of nursing licensure, focusing on members with behavioral health needs, complex medical conditions, intellectual and developmental disabilities, and those receiving Medicaid waiver services. The Case Manager develops, implements, evaluates, and revises individualized care plans designed to improve health outcomes, promote independence, and enhance quality of life.This role conducts telephonic and face-to-face assessments to identify, coordinate, and manage members' physical health, behavioral health, social determinants of health, long-term services and supports (LTSS), and community resource needs.Key ResponsibilitiesPerform comprehensive assessments of members with complex medical, behavioral health, and social needs.Manage a caseload consisting primarily of members enrolled in waiver programs, behavioral health programs, and complex care management initiatives.Develop and maintain individualized care plans that address physical health, behavioral health, long-term services and supports, and social service needs.Coordinate care with members, caregivers, providers, behavioral health professionals, community agencies, and interdisciplinary care teams.Identify members at risk for adverse outcomes and implement interventions to reduce avoidable hospitalizations and emergency department utilization.Facilitate access to waiver services, community resources, behavioral health treatment, and specialty care.Monitor member progress, close gaps in care, and support quality improvement initiatives.Present complex cases during interdisciplinary case conferences and collaborate with Medical Directors, Physician Advisors, Behavioral Health teams, and community partners.Assist with authorization, referral, and service coordination processes in accordance with benefit plans and regulatory requirements.Maintain compliance with all regulatory, accreditation, and organizational policies and procedures.QualificationsEducationAssociate Degree in Nursing requiredBachelor's Degree in Nursing (BSN) preferredLicensureActive Registered Nurse (RN) license requiredExperienceMinimum of three (3) years of clinical nursing experience requiredExperience in care management, case management, behavioral health, managed care, Medicaid populations, waiver services, or community-based care strongly preferredExperience working with individuals with complex medical, behavioral health, intellectual/developmental disability, or long-term care needs preferredWe 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, 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.