Integrated Nurse Case Manager/RN/Maternity/OBGYN

Sentara Health; King George (VA); Remote; USD 70,000 - 90,000; Full time

Job summary

Sentara Health seeks an Integrated Nurse Case Manager/RN for a full-time, work-from-home role primarily serving the Tappahannock, Northumberland, and King George areas. Responsibilities include case management and clinical assessments, focusing on optimizing member health care within regulatory frameworks. The role requires an RN license, nursing degree, and experience in managing a variety of healthcare needs with a competitive sign-on bonus offered.

Benefits

Medical, Dental, Vision plans

401k/403B with Employer Match

Tuition Assistance – $5,250/year

Sign-on bonus available

Paid Time Off and Sick Leave

Qualifications

• 3 years experience in Nursing required.
• Registered Nurse (RN) License is mandatory.
• Experience in case management preferred.

Responsibilities

• Develops, monitors, evaluates, and revises member care plans.
• Conducts clinical assessments for member needs.
• Coordinates care for high-risk members with health care teams.

Skills

Communication

Problem-Solving

Analytical Thinking

Education

Associate or Bachelors Degree in Nursing

Job description

Integrated Nurse Case Manager/RN/Maternity/OBGYN

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Integrated Nurse Case Manager/RN/Maternity/OBGYN

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Overview:

Tappahannock, Northumberland, King George, VA and surrounding areas!

Sign-on bonus offer to qualified applicants!

This is a full-time, work-from-home position that requires travel to conduct face-to-face home visits in the member’s home or other locations for Tappahannock, Northumberland, King George, VA and surrounding areas.

Status: Full-time, permanent position (40 hours)

Standard working hours: 8am to 5pm EST, M-F

, Northumberland, King George, VA and surrounding areas!

• 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 or face-to-face 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.
  
  
  

City/State

King George, VA

Work Shift

First (Days)

Overview:

Sentara Health Plans is hiring an Integrated Nurse Case Manager/RN/Maternity/OBGYN for Tappahannock, Northumberland, King George, VA and surrounding areas!

Sign-on bonus offer to qualified applicants!

This is a full-time, work-from-home position that requires travel to conduct face-to-face home visits in the member’s home or other locations for Tappahannock, Northumberland, King George, VA and surrounding areas.

Status: Full-time, permanent position (40 hours)

Standard working hours: 8am to 5pm EST, M-F

Location: Applicants must be reside in Tappahannock, Northumberland, King George, VA and surrounding areas!

Primary responsibilities include:

• 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 or face-to-face 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.
  
  
  

Education:

• Associate or Bachelors Degree in Nursing REQUIRED
  
  
  

Certification/Licensure:

• Registered Nurse (RN) License (Compact or Virginia) REQUIRED
  
  
  

Experience:

• 3 years experience in Nursing REQUIRED
• Case Management experience preferred
• Managed Care or Health Plan experience preferred
• Experience working with low and high risk pregnant population/Maternity/OB/L&D/Mother Baby/Postpartum experience preferred
• Strong knowledge of physical, psychological, socio-cultural, and cognitive patient needs.
• Excellent communication skills, both oral and written, as well as strong problem-solving and analytical
  
  
  

Sentara Health Plans provides health plan coverage to close to one million members in Virginia. We offer a full suite of commercial products including employee-owned and employer-sponsored plans, as well as Individual & Family Health Plans, Employee Assistance Programs and plans serving Medicare and Medicaid enrollees.

Our quality provider network features a robust provider network, including specialists, primary care physicians and hospitals.

We offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services—all to help our members improve their health.

Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth.

Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve!

To apply, please go to www.sentaracareers.com and use the following as your Keyword Search: JR-81928

#Indeed

Talroo - Nursing

Care Coordination, Case Management, RN, Case Manager, Registered Nurse, BSN, ADN, Nursing, Managed Care, MCO, Health Plan, high-risk pregnant members, Maternity, OBGYN, Labor and Delivery, Mother and Baby, Postpartum, Tappahannock, Northumberland, King George, VA

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.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care

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