Remote Integrated Care Manager (RN) – Appeals Expert

Sentara Health; Virginia; Remote; USD 90,000 - 136,000; Full time

Benefits offered by this job

Medical, Dental, Vision plans

Paid Time Off and Sick Leave

401k/403B with Employer Match

Tuition Assistance

Student Debt Pay Down

Life Insurance

Job summary

Sentara Health Plans is seeking an Integrated Care Manager/Registered Nurse (RN) for inpatient and outpatient clinical appeals, with remote work option in Virginia. This full-time role offers standard hours 8am–5pm EST, Monday–Friday, and requires 3 years of nursing experience plus RN licensure in VA or compact states.

The position emphasizes review of denials, root-cause analysis, and supporting appeal submissions across government and commercial payers.

Qualifications

• RN Diploma required; BSN preferred.
• 3 years nursing experience required.
• Rev Cycle/UR/Case Management knowledge preferred.

Responsibilities

• Manage inpatient and outpatient provider appeals across payer types.
• Review clinical denials and perform post-claim analysis to support submissions.

Skills

RN experience

Excel proficiency

Education

RN Diploma

BSN preferred

Job description

Sentara Health Plans is seeking an Integrated Care Manager/Registered Nurse (RN) for inpatient and outpatient clinical appeals, with remote work option in Virginia. This full-time role offers standard hours 8am–5pm EST, Monday–Friday, and requires 3 years of nursing experience plus RN licensure in VA or compact states.

The position emphasizes review of denials, root-cause analysis, and supporting appeal submissions across government and commercial payers.