Integrated Case Manager- RN (Northern Virginia)

176 Managed Care Services, Inc.; Fairfax (VA); Híbrido; USD 90.000 - 136.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical, Dental, Vision plans

401k with Employer Match

Paid Time Off and Sick Leave

Parental & Family Caregiver Leave

Life Insurance

Discretionary bonus eligibility

Descripción de la vacante

Sentara Health is seeking an Integrated Case Manager (RN) to deliver comprehensive case management, clinical assessments, and care coordination for members across physical, behavioral health, and social services. This role requires travel to Arlington, Alexandria, Fairfax, and Leesburg areas, with in-person assessments and a remote component.

The ideal candidate has 3+ years of nursing experience, RN certification, and experience in managed care or discharge planning.

Formación

• Associates/Bachelors preferred; RN certification required.
• 3 years nursing experience; managed care preferred.
• Discharge planning experience preferred.

Responsabilidades

• Develops, monitors, and revises member care plans to optimize health outcomes.
• Performs telephonic clinical assessments for identification and coordination of needs.
• Identifies high-risk members and coordinates care with medical teams and services.
• Facilitates authorizations/referrals within benefits structure and contracts.

Conocimientos

Case management

Managed care

Discharge planning

Telephonic assessments

Interdisciplinary collaboration

Educación

RN certification

Associates degree

Bachelors degree preferred

Descripción del empleo

Overview

City/State Fairfax, 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 Arlington, Alexandria, Fair Fax and Leesburg area.

Responsibilities

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 & Credentials

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.

Compensation

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.

Benefits

• 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.

Diversity & Inclusion

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.

Remote Work Locations

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.

About Sentara

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!