Integrated Case Manager- RN (Danville VA)

Sentara Hospitals; Danville (VA); Hybrid; USD 90,000 - 136,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Life insurance

Disability insurance

401(k) with employer match

Paid time off

Job summary

Sentara Health is seeking an Integrated Case Manager (RN) to conduct telephonic and in-person assessments, develop comprehensive care plans, and coordinate care for members across physical and behavioral health services. Travel to Danville, South Boston, Ringgold, Dry Fork, and Chatham areas is required, with a focus on discharge planning and managed care.

The role requires an RN with at least 3 years of nursing experience; associates degree is minimum with bachelor’s preferred.

Qualifications

• Associates degree required or equivalent
• Bachelor's degree preferred for preferred candidacy
• Registered Nurse (RN) required

Responsibilities

• Conduct telephonic clinical assessments to identify, evaluate, coordinate and manage member needs across physical, behavioral health and social services.
• Develop and revise the member care plan to optimize health outcomes across the care continuum.
• Identify high‑risk members and coordinate care with the health care team.
• Assist with authorizations/referrals within benefits structure or extra-contractual arrangements.
• Interface with Medical Directors, Physician Advisors and Inter-Disciplinary Teams on care management plans.
• Present cases at case conferences for multidisciplinary focus and ensure regulatory compliance.
• Assist in problem solving with providers, claims or service issues.

Skills

Case management

Telephonic assessments

Nursing expertise

Discharge planning

Education

Associates

Bachelor's degree preferred

Job description

City/State

Danville, 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 Danville, South Boston, Ringgold, Dry Fork, Chatham area.

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.