Integrated Case Manager Registered Nurse

Sentara Health Plans; Virginia Beach, Northern (VA, KY); On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

Medical, Dental, Vision plans

Paid Time Off and Sick Leave

401k/403B with Employer Match

Tuition Assistance

Job summary

Sentara Health is seeking a Remote Integrated Case Manager (RN) to coordinate medical, behavioral health, and social needs for members in Virginia Beach and surrounding areas. The role includes telephonic and in-person assessments, care plan development, and cross-functional collaboration to optimize outcomes.

The position requires an RN license, an associate degree (BSN preferred), and 3 years of nursing experience with managed care or disease management experience preferred.

Qualifications

• Associates degree required; BSN preferred.
• Registered Nurse license required.
• 3 years of nursing experience required.
• Managed care or disease management experience preferred.
• Strong communication and analytical skills.

Responsibilities

• Perform telephonic and face-to-face assessments to identify and coordinate member needs.
• Develop and revise member care plans across care continuum.
• Coordinate authorizations/referrals within benefits structure.
• Collaborate with Medical Directors and care teams.
• Assist in discharge planning and problem solving with providers.

Skills

Case management

Nursing

Communication

Interpersonal skills

Problem solving

Analytical thinking

Education

Associates degree

BSN

Tools

EMR systems

Job description

## Integrated Case Manager Registered NurseApplyremote type: Remotelocations: Virginia Beach, VAtime type: Full timeposted on: Posted Todayjob requisition id: JR-104654**City/State**Virginia Beach, VA**Work Shift**First (Days)**Overview:****Sentara Health is looking to hire a Remote Integrated Case Manager.****Candidates must reside in the State of Virgina.**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 and face to face as needed 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. Ensures 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:**· Associates (required)· BSN (preferred)**Certification:**· Registered Nurse (required)**Experience:**· 3 years of nursing experience (required)· Managed care (preferred)· Disease Management experience (preferred) Keywords: Talroo- Health, Disease Management, Case Management, Managed Care, Discharge Planning **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.