Integrated Case Manager- RN
About The Position
Sentara Health is seeking an Integrated Case Manager, RN, to provide case management services within the scope of licensure. The role develops, monitors, evaluates, and revises member care plans to address individual needs and optimize health care across the care continuum. The position performs telephonic clinical assessments to identify, evaluate, coordinate, and manage members’ physical and behavioral health, social service, and long-term service needs. The position is remote but requires in-person face-to-face assessments. Candidates must be able to travel to the Bowling Green, Tappahannock, and Henrico areas. It is a full-time, 40-hour-per-week role on a day shift, 8 a.m. to 5 p.m.
Requirements
- Associate degree.
- Registered Nurse (RN) licensure required.
- At least 3 years of nursing experience.
- Strong oral, written, and interpersonal communication skills.
- Problem-solving, facilitation, and analytical skills.
- Ability to travel to Bowling Green, Tappahannock, and Henrico areas for in-person assessments.
Nice To Haves
- Bachelor’s degree preferred.
- Managed care experience preferred.
- Discharge planning experience preferred.
Responsibilities
- Develop, monitor, evaluate, and revise member care plans to meet member needs and optimize care across the care continuum.
- Perform telephonic clinical assessments to identify, evaluate, coordinate, and manage members’ physical and behavioral health, social service, and long-term service needs.
- Identify members at risk for complications and coordinate care with members and the health care team.
- Manage chronic illnesses, comorbidities, and disabilities while supporting cost-effective and efficient use of health benefits.
- Conduct gap-in-care management for quality programs.
- Facilitate authorizations and referrals within the benefits structure or through permissible extra-contractual arrangements to help implement member care plans.
- Coordinate with Medical Directors, Physician Advisors, and/or Inter-Disciplinary Teams on care management treatment plans.
- Present cases at multidisciplinary case conferences.
- Ensure compliance with regulatory, accrediting, and company policies and procedures.
- Assist in resolving provider, claims, or service issues as needed.
- Address patients’ individualized physical, psychological, sociocultural, spiritual, cognitive, and functional needs.
Benefits
- Medical insurance
- Dental insurance
- Vision insurance
- Life insurance
- Disability insurance
- 401(k)/403(b) with employer match
- Paid time off, including vacation, sick time, and holidays
- Paid parental and military leave
- Adoption, fertility, and surrogacy reimbursement up to $10,000
- Family caregiver leave
- Emergency backup care
- Critical illness plans
- Tuition assistance of $5,250 per year and discounted educational opportunities through Guild Education
- Student debt pay down up to $10,000
- Pet insurance
- Legal resources plan
- Opportunity to earn an annual discretionary bonus, subject to eligibility criteria
- Educational assistance or student loan repayment
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
