Integrated Case Manager- RN (Northern Virginia)
About The Position
Sentara Health is hiring a full-time Integrated Case Manager, RN. The position is remote but requires in-person, face-to-face assessments, and candidates must be able to travel to the Arlington, Alexandria, Fairfax, and Leesburg areas of Virginia. The schedule is a day shift, 8:00 a.m. to 5:00 p.m., for 40 hours per week. The Integrated Case Manager provides case management services within the scope of RN licensure. The role develops, monitors, evaluates, and revises member care plans to address individual needs and optimize health care across the care continuum. It performs telephonic clinical assessments to identify, evaluate, coordinate, and manage members’ physical and behavioral health, social service, and long-term service needs. The role identifies members at risk for complications and coordinates care with members and their health care teams. It manages chronic illnesses, comorbidities, and disabilities while supporting cost-effective and efficient use of health benefits, and conducts gap-in-care management for quality programs. The case manager facilitates authorizations and referrals within the benefits structure or through permissible extra-contractual arrangements, collaborates with Medical Directors, Physician Advisors, and interdisciplinary teams on treatment plans, and presents cases at multidisciplinary conferences. The role also ensures compliance with regulatory, accrediting, and company policies and procedures, and may help resolve provider, claims, or service issues. The position requires knowledge and skills to address patients’ individualized physical, psychological, sociocultural, spiritual, and cognitive needs, as well as functional abilities. Sentara offers a comprehensive benefits package and market-competitive compensation. The posted full-time base pay range is $89,544.00–$136,468.80 annually; compensation may vary, and additional compensation may be available.
Requirements
- Registered Nurse certification/licensure is required.
- Associate degree required.
- At least 3 years of nursing experience required.
- Strong oral, written, and interpersonal communication skills.
- Problem-solving, facilitation, and analytical skills.
- Ability to travel for in-person face-to-face assessments in the Arlington, Alexandria, Fairfax, and Leesburg areas.
Nice To Haves
- Bachelor’s degree preferred.
- Managed care experience preferred.
- Discharge planning experience preferred.
Responsibilities
- Provide case management services within the scope of RN licensure.
- Develop, monitor, evaluate, and revise member care plans to address member needs and optimize health care across the care continuum.
- Perform telephonic clinical assessments to identify, evaluate, coordinate, and manage physical and behavioral health, social service, and long-term service needs.
- Identify members at risk for high-risk complications and coordinate care with members and their health care teams.
- Manage chronic illnesses, comorbidities, and disabilities while supporting cost-effective and efficient utilization 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.
- Coordinate with Medical Directors, Physician Advisors, and interdisciplinary teams on care management treatment plans.
- Present cases at multidisciplinary case conferences.
- Ensure compliance with regulatory, accrediting, and company policies and procedures.
- May assist in resolving provider, claims, or service issues.
- Address patients’ individualized physical, psychological, sociocultural, spiritual, and cognitive needs and functional abilities.
Benefits
- Medical, dental, and vision plans
- Adoption, fertility, and surrogacy reimbursement up to $10,000
- Paid time off and sick leave
- Paid parental and family caregiver leave
- Emergency backup care
- Long-term and short-term disability and critical illness plans
- Life insurance
- 401(k)/403(b) with employer match
- Tuition assistance up to $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
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
