Remote RN Integrated Case Manager: Care Coordination

Sentara Health; Madison (WI); Remote; USD 90,000 - 136,000; Full time

Benefits offered by this job

Medical, dental, vision plans

401(k)/403(b) with employer match

Paid time off (vacation, sick time, &

Holidays

Educational assistance

Student loan repayment

Tuition assistance

Bonus opportunities

Job summary

Sentara Health is seeking an Integrated Case Manager (RN) to provide telephonic assessments and in-person care planning for members in Roanoke and surrounding areas. The role involves travel up to 60-90 minutes weekly to see members, with 50-75% of the time spent in the field.

You will develop and monitor care plans, coordinate with the care team, and ensure regulatory and policy compliance across the care continuum. RN certification and 3 years nursing experience are required.

Qualifications

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

Responsibilities

• Develop, monitor, evaluate, and revise the member's care plan to optimize health care across the continuum.
• Perform telephonic clinical assessments for identification, evaluation, coordination and management of member's needs.
• Identify high-risk members and coordinate care with the health care team.
• Manage chronic illnesses, co-morbidities, and disabilities to ensure cost effective utilization of benefits.
• Assist with implementation of member care plans by facilitating authorizations/referrals within benefits structure.
• Interface with Medical Directors, Physician Advisors and Inter-Disciplinary Teams on care management treatment plans.
• Present 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.

Skills

Case management

Nursing experience

Discharge planning

Managed care

Education

Associates

Bachelors preferred

Job description

Sentara Health is seeking an Integrated Case Manager (RN) to provide telephonic assessments and in-person care planning for members in Roanoke and surrounding areas. The role involves travel up to 60-90 minutes weekly to see members, with 50-75% of the time spent in the field.

You will develop and monitor care plans, coordinate with the care team, and ensure regulatory and policy compliance across the care continuum. RN certification and 3 years nursing experience are required.