Integrated Case Manager- RN

Sentara Health; Virginia (MN); On-site; USD 75,000 - 95,000; Full time

Benefits offered by this job

401k/403b with employer match

Tuition Assistance

Paid Time Off & Sick Leave

Parental & Family Caregiver Leave

Life Insurance

Job summary

Sentara Health in Norfolk, VA seeks an Integrated Case Manager (RN) to develop, monitor, and revise care plans across the care continuum, performing telephonic clinical assessments and coordinating physical, behavioral health, social services, and long-term services.

The role requires 3 years nursing experience, RN licensure, and prefers discharge planning and managed care experience; diverse benefits and professional development opportunities are offered.

Qualifications

• 3 years of nursing experience required.
• Discharge planning experience preferred.
• Managed care experience preferred.
• Strong oral, written and interpersonal communication skills.

Responsibilities

• Perform telephonic clinical assessments for identification, evaluation and management of member needs.
• Identify high-risk members and coordinate care with the health care team.
• Manage chronic illnesses and co-morbidities to optimize benefit utilization.
• Facilitate authorizations/referrals within benefits structure or external arrangements.

Skills

Case management

Nursing

Communication

Analytical skills

Education

Associates degree

Bachelor's degree preferred

Job description

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

City/State: Norfolk, VA

Work Shift: First (Days)

Education

• Associates
• Bachelors preferred

Certification

• Registered Nurse required

Experience

• 3 years of nursing experience required
• Managed care preferred
• Discharge planning experience preferred

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
• Reimbursement for certifications and free access to complete CEUs and professional development
• 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.