Integrated Case Manager

Sentara Health; Sioux Falls (SD); Hybrid; USD 90,000 - 136,000; Full time

Benefits offered by this job

Medical/Dental/Vision

401(k) with employer match

Paid time off

Parental leave

Educational assistance

Student debt pay down

Pet Insurance

Legal resources plan

Annual bonus opportunities

Job summary

Sentara Health is seeking an Integrated Case Manager, RN to coordinate and manage member care across the continuum. The role offers remote work with required in-person assessments and travel within Roanoke and surrounding areas up to 60–90 minutes, roughly 50–75% of weeks.

You will develop and monitor individualized care plans, conduct telephonic assessments, and collaborate with medical directors, physicians and care teams to optimize outcomes while ensuring regulatory and policy compliance.

Qualifications

• Registered Nurse with 3 years nursing experience.
• Managed care or discharge planning experience preferred.
• Associates or Bachelors degree preferred.
• Strong communication and collaboration skills.

Responsibilities

• Coordinate and manage member care plans across the continuum.
• Perform telephonic clinical assessments and identify high-risk members.
• Collaborate with Medical Directors, Physician Advisors, and care teams.
• Ensure regulatory compliance and policy adherence.

Skills

Oral communication

Written communication

Interpersonal skills

Problem-solving

Facilitation

Analytical skills

Education

Associate degree

Bachelor's degree

Job description

City/State

Roanoke, VA

Work ShiftFirst (Days)

Overview: Sentara Health is looking to hire an Integrated Case Manager, RN. This Position is remote but does require in person face-to-face assessments. Candidates must be able to travel to Roanoke and northern areas as travel is required up to 60- 90 minutes to see members approximately 50 to 75% a week. 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 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 skills.

Education: AssociatesBachelors 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 Planning

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: 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.