Integrated Case Manager- RN

Sentara Health; Richmond (VA); Hybrid; USD 90,000 - 136,000; Full time

Benefits offered by this job

Medical, Dental, Vision plans

401(k) with employer match

Paid Time Off

Educational assistance

Student debt pay down

Job summary

Sentara Health in Richmond, VA is seeking an Integrated Case Manager, RN on a full-time basis. This role combines remote work with required in-person assessments and regional travel to partner sites.

The nurse will oversee care plans, coordinate services, and ensure optimal health outcomes across the care continuum. The ideal candidate has an RN license, 3 years of nursing and preferred managed care or discharge planning experience.

Qualifications

• Requires RN licensure and at least 3 years of nursing experience.
• Associates or Bachelor's degree; Bachelor's degree preferred.
• Managed care and discharge planning experience preferred.
• Strong communication, problem-solving, facilitation, and analytical skills.

Responsibilities

• Performs telephonic and face-to-face assessments to identify and manage member needs.
• Develops and monitors care plans across physical, behavioral health, social services, and long-term care.
• Coordinates authorizations/referrals within benefits structure.
• Collaborates with Medical Directors and care teams; presents cases at conferences.
• Supports problem solving with providers, claims, or service issues.

Skills

Interpersonal communication

Problem-solving

Facilitation

Analytical skills

Care coordination

Education

Associate's degree

Bachelor's degree preferred

Job description

City/State Richmond, VA

Work Shift First (Days) Overview

Sentara Health is looking to hire an Integrated Case Manager, RN. Status: Full Time (40 hrs/wk) Shift: Day (8am-5pm) This Position is remote but does require in person face-to-face assessments. Candidates must be able to travel to King George, Tappahannock, Doswell, Ashland, Bowling Green. 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

Associates 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 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.

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!