Integrated Case Manager

Sentara Health Plan 9R; Harrisonburg (VA); On-site; USD 90,000 - 136,000; Full time

Benefits offered by this job

Medical/Dental/Vision plans

Paid Time Off

Tuition Assistance

Student Debt Pay Down

Life Insurance

401k/403B match

Discretionary bonus

Job summary

Sentara Health Plan in Harrisonburg, VA is seeking an Integrated Case Manager (RN) to coordinate care for medically and behaviorally complex members. This role involves in-person assessments as well as remote telephonic evaluations for individuals with Serious Mental Illnesses, Serious Emotional Disturbances (2+) and Substance Abuse Disorders.

The position requires an RN license, 3 years of nursing experience, and experience with discharge planning or managed care is preferred.

Qualifications

• Associates degree is required.
• Bachelor's degree is preferred.
• Registered Nurse (RN) licensure is required.
• Minimum 3 years of nursing experience.
• Managed care experience is preferred.
• Discharge planning experience is preferred.

Responsibilities

• Perform in-person and telephonic assessments to identify needs.
• Develop, monitor and revise the member care plan across physical and behavioral health, social services, and long-term care.
• Identify high-risk members and coordinate care with the health care team.
• Facilitate authorizations/referrals within the benefits structure and external arrangements.

Skills

Interpersonal skills

Written communication

Oral communication

Problem solving

Facilitation

Analytical skills

Education

Registered Nurse license (RN)

Associates degree

Bachelor's degree preferred

Job description

City/StateHarrisonburg, VAWork ShiftFirst (Days)Overview:Sentara Health in Harrisonburg VA is looking to hire an Integrated Case Manager, RN.This position will work with members under Sentara Health Plans who are both medically and behaviorally complex.This position requires both in-person/face-to-face assessments and remote telephonic assessments for members with Serious Mental Illnesses, Serious Emotional Disturbances (ages 2+) and Substance Abuse Disorders!Location: Applicants must be in Harrisonburg, area VA. Travel may include up to 90 minutes one way.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:· Associates (required)· Bachelors (preferred)Certification:· Registered Nurse (required)Experience:· 3 years of nursing experience (required)· Managed care (preferred)· Discharge planning experience (preferred)Keywords: 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, overtime, 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.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.