NURSE CASE MGR Tidewater

CityState

Virginia Beach, VA

Work Shift

First (Days)

Overview:

Sentara Health is seeking a dedicated Nurse Case Manager for the Tidewater, VA region!

This fulltime, workfromhome position requires travel to conduct facetoface home visits in the member’s home or other locations within the Tidewater, VA region. Travel coverage includes Hampton Road, Newport News, Portsmouth, Suffolk, Chesapeake .The members will be predominantly in the above areas and possibly the Virginia Beach & Norfolk.

Primary responsibilities include:

• Responsible for case management services within the scope of licensure; develops, monitors, evaluates, and revises the members care plan to meet the members needs, with the goal of optimizing member health care across the care continuum

• Performs telephonic or facetoface clinical assessments for the identification, evaluation, coordination and management of members needs, including physical and behavioral health, social services and longterm services

• Identifies members for highrisk complications and coordinates care in conjunction with the member and health care team

• Manages chronic illnesses, comorbidities, andor 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 authorizationsreferrals within benefits structure or extracontractual arrangements, as permissible

• Interfaces with Medical Directors, Physician Advisors andor InterDisciplinary 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: Private duty nursing experience and knowledgeable with ventilators in a facility or home

  Education

  • Associates or Bachelors Degree in Nursing

  • CertificationLicensure

    • Registered Nurse License (RN) Nursing License CompactMultiState License required.

    • Experience

      • 3 years experience in Nursing

      • Discharge planning experience preferred

      • Managed Care experience preferred

      • Preferred: Private duty nursing and knowledgeable with ventilators in a facility or home

      • Keywords: Care Coordination, Case Management, Human Services, Community Health, Health Education, RN Case Manager, Registered Nurse, BSN, ADN, Private Duty, Ventilator, LinkedIn, TalrooNursing

        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
        • LongTerm, ShortTerm Disability, and Critical Illness plans
        • Life Insurance
        • 401k403B with Employer Match
        • Tuition Assistance – $5,250year 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 30,000member 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 tobaccofree 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.