Integrated Care Manager- Eastern Shore

Sentara Health; United States; Remote; USD 90,000 - 136,000; Full time

Benefits offered by this job

Medical, Dental, Vision plans

Adoption, Fertility and Surrogacy Reim

Paid Time Off and Sick Leave

Paid Parental & Family Caregiver Leave

Emergency Backup Care

Long-Term, Short-Term Disability

Life Insurance

401k/403B with Employer Match

Tuition Assistance - $5,250/year

Student Debt Pay Down - $10,000

Pet Insurance

Legal Resources Plan

Job summary

Sentara Health is seeking an Integrated Case Manager, RN to support Eastern Shore residents with behavioral health, waiver services, and complex care management. The role combines telephonic and in-home assessments, with travel up to 50%–75% of the workweek.

Remote position requiring Virginia residency and regular in-home/community visits. Strong emphasis on care coordination and regulatory compliance to improve outcomes and quality of life.

Qualifications

• RN with licensure and nursing background in case management.
• Experience with Medicaid waiver programs, behavioral health, and complex care management preferred.
• Regulatory compliance and care coordination experience required.

Responsibilities

• Perform comprehensive assessments of members with complex medical, behavioral health, and social needs.
• Manage a caseload primarily of waiver and behavioral health programs.
• Develop and maintain individualized care plans addressing health, behavioral health, long-term supports, and social needs.
• Coordinate care with members, caregivers, providers, and interdisciplinary teams.
• Identify at-risk members and implement interventions to reduce avoidable hospitalizations.
• Facilitate access to waiver services and community resources.
• Monitor progress, close gaps in care, and support quality improvement.
• Present complex cases at interdisciplinary conferences with Medical Directors and partners.
• Assist with authorization, referral, and service coordination processes.
• Maintain compliance with regulatory and organizational policies.

Skills

Case management

Nursing

Behavioral health

Care coordination

Telephonic assessments

In-home visits

Waiver services

Complex care

Education

Associate Degree in Nursing

Bachelor's Degree in Nursing (BSN) preferred

Job description

City/State Newport News, VA Work Shift First (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 Overview

The 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 Responsibilities

• Perform 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.

Qualifications

Education Associate Degree in Nursing required Bachelor's Degree in Nursing (BSN) preferred Licensure Active Registered Nurse (RN) license required Experience Minimum of three (3) years of clinical nursing experience required Experience in care management, case management, behavioral health, managed care, Medicaid populations, waiver services, or community-based care strongly preferred Experience working with individuals with complex medical, behavioral health, intellectual/developmental disability, or long-term care needs preferred We 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

• 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

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.

Sentara Health is a Virginia and Northeastern North Carolina based not-for-profit integrated healthcare provider that has been in business for over 131 years. Offering hundreds of sites of care including 12 hospitals, PACE, home health, hospice, medical groups, imaging services, therapy, outpatient surgery centers, and an 858,000 member health plan.

The people of the communities that we serve have nominated Sentara “Employer of Choice” for over ten years. U.S. News and World Report has recognized Sentara as having the Best Hospitals for 15+ years. Sentara offers professional development and a continued employment philosophy!