Offer summary

Qualifications:

Associate's or Bachelor's Degree in Nursing required., Registered Nurse License (RN) - Compact/Multi-State License required., 3 years of experience in Nursing, with discharge planning and managed care experience preferred., Knowledge of LTSS, Medicaid, waiver population case management, and familiarity with DMAS and Epic is preferred..

Key responsibilities:

Responsible for case management services, developing and revising member care plans.

Conducts telephonic and face-to-face clinical assessments to evaluate member needs.

Coordinates care for high-risk members in collaboration with healthcare teams.

Presents cases at conferences and ensures compliance with regulatory and company policies.

Job description

City/State

Virginia Beach, VA

Work Shift

First (Days)

Overview:

Sentara Healthcare is currently hiring an Integrated RN Case Manager for the Virginia Beach/Norfolk, VA market.

This is a Full-Time position with day shift hours and great benefits!

The position requires both in-person face-to-face assessments and remote telephonic assessments in and around Virginia Beach, Norfolk, and surrounding communities.

*Applicants must reside within driving distance.

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

Preferred: LTSS, Medicaid, waiver population case management experience, and knowledge of DMAS and Epic

Education

Associate's or Bachelors Degree in Nursing

Certification/Licensure

Registered Nurse License (RN) - Nursing License - Compact/Multi-State License required.

Experience

3 years experience in Nursing
Discharge planning experience preferred
Managed Care experience preferred
Preferred: LTSS, Medicaid, waiver population case management experience, and knowledge of DMAS and Epic

Keywords: Care Coordination, Case Management, Human Services, Community Health, Health Education, RN Case Manager, Registered Nurse, BSN, LinkedIn, Monster, Talroo-Nursing, Cardinal, Medicaid, DMAS, MCO, managed care, LTSS, long-term services support, transition of care, discharge planning, community outreach

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.

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