Temp Registered Nurse Medicare Case Manager - Remote (Virginia Only)

Sentara; Virginia, Virginia Beach (MN, VA); Remote; USD 80,000 - 100,000; Full time

Job summary

An innovative healthcare organization is seeking a Temporary RN Case Management/Care Coordinator to enhance the Medicare Chronic Special Needs Program. This role involves developing and managing care plans, conducting assessments, and coordinating care for patients with chronic conditions. The position offers a unique opportunity to work remotely from Virginia, providing vital support to members while ensuring compliance with healthcare regulations. Join a diverse and dedicated team committed to improving health every day, where your contributions will make a significant impact in the lives of many.

Benefits

Medical, Dental, Vision plans

Adoption, Fertility and Surrogacy Reimbursement

Paid Time Off and Sick Leave

Paid Parental & Family Caregiver Leave

Emergency Backup Care

Long-Term and Short-Term Disability plans

Life Insurance

401k/403B with Employer Match

Tuition Assistance

Pet Insurance

Qualifications

• 3+ years of RN experience required, preferably in case management.
• Experience with pulmonary, cardiac, and diabetic patients is a plus.

Responsibilities

• Develop and manage care plans for members, optimizing their healthcare.
• Conduct clinical assessments and coordinate care with healthcare teams.

Skills

Case Management

Care Coordination

Telephonic Assessments

Chronic Illness Management

Patient Evaluation

Education

RN Diploma

BSN preferred

Tools

JIVA

Job description

City/State

Williamsburg, VA

Work Shift

First (Days)

Overview:

Sentara Health Plan is hiring a Temporary RN Case Management/Care Coordinator for the Medicare Chronic Special Needs Program (C-SNP).

*Estimated 6 month temporary assignment.

This is a Temporary, 40 hours per week day shift position, Mon-Fri, between 8:00 am - 5:00 pm.

The position is remote - work from home is available only in Virginia.

Temporary positions do not offer benefits, and the pay rate is firm at $47.25/hr.

RN Clinician 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 healthcare 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 providers, claims, or service issues.

Education

• RN Diploma
• BSN preferred

Certification/Licensure

• RN License (Required)

Experience

• Three years of RN experience required.
• Acute care experience in a hospital setting, specifically with Pulmonary, Cardiac, and Diabetic patients or previous Medicare Case Management/Care Coordination preferred.

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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 are 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.