About The Position
Sentara Health Plans is hiring a Care Coordinator/ Licensed Practical Nurse (LPN) for LTSS Waiver/ Home Health in Culpeper, Warrenton, Fauquier, Catlett, Madison, Orange, Brightwood, Bealeton, Washington, Rappahannock County, Gordonsville, VA! This is a full-time, permanent position with standard working hours of 8am to 5pm EST, Monday through Friday. The role requires a blend of in-person assessments and remote work from a home office for the LTSS Waiver population. The candidate must reside within the specified service areas in Virginia. Sentara Health Plans provides health plan coverage to close to one million members in Virginia, offering a full suite of commercial products, as well as plans serving Medicare and Medicaid enrollees. The organization emphasizes a family-friendly culture, community involvement, and opportunities for development and growth, with a mission to improve health every day.
Requirements
- 3 years Managed Care experience REQUIRED
- Licensed Practical Nurse (LPN) or Bachelor's prepared health professional strongly preferred.
- LPN license in VA or Compact/Multistate preferred
- Associate's degree in Nursing preferred.
- Bachelor's degree in Health & Human Services-related field or related experience in lieu of education accepted.
Nice To Haves
- Case Management experience preferred
- Long-Term Services and Supports (LTSS) waiver and Home Health experience preferred
- Behavioral Health experience is secondary
Responsibilities
- Facilitation, implementation, and coordination of the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Member Outreach Program and overall compliance with immunization and EPSDT examinations.
- Serving as a health plan resource for the EPSDT/Well Child Program and all childhood exams, screenings, and vaccinations recommended by DMAS and per HEDIS measures.
- Data entry and monitoring of reports to increase utilization of EPSDT services.
- Maintaining a tracking system to identify new enrollees and children's non-compliance with EPSDT periodicity and immunization schedules.
- Ensuring access to periodic preventive health care for members under the age of 21 years by promoting and coordinating child wellness in alignment with DMAS, health plan, and other professional organization initiatives.
- Conducting notifications of periodic screening requirements; developing educational materials and providing training to members/providers.
- Triaging members with special healthcare needs (CSHN) using appropriate screening tools and assessments.
- Providing complex case management to members with complex needs.
- Performing related field work and community engagement travel as needed to increase EPSDT awareness and compliance.
- Assisting with EPSDT policies/procedures and completing service authorizations.
Benefits
- 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.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
