Integrated Case Manager- RN (Danville VA)

Sentara Hospitals•Danville, VA

3d•Remote

About The Position

Sentara Health is hiring an Integrated Case Manager, RN. This full-time role is remote but requires in-person, face-to-face assessments. The candidate must be able to travel to the Danville, South Boston, Ringgold, Dry Fork, and Chatham areas. The schedule is 8 a.m.–5 p.m., first shift, 40 hours per week. The Integrated Case Manager provides case management services within the scope of licensure and develops, monitors, evaluates, and revises members’ care plans to address their needs and optimize health care across the care continuum. The role includes telephonic clinical assessments to identify, evaluate, coordinate, and manage members’ physical and behavioral health, social service, and long-term service needs. The Case Manager identifies members at risk of complications and coordinates care with members and their health care teams. The position manages chronic illnesses, co-morbidities, and disabilities while supporting cost-effective, efficient use of health benefits, and conducts gap-in-care management for quality programs. It supports care-plan implementation by facilitating authorizations and referrals within benefit structures or permissible extra-contractual arrangements. The Case Manager interfaces with Medical Directors, Physician Advisors, and interdisciplinary teams regarding care-management treatment plans, presents cases at multidisciplinary conferences, and ensures compliance with regulatory, accrediting, and company policies and procedures. The role may also assist with provider, claims, or service issues. The role requires knowledge and skills to address individualized patient needs, including physical, psychological, sociocultural, spiritual, cognitive, and functional needs. Sentara offers a market-competitive compensation package. The stated annual base-pay range for full-time employment is $89,544.00–$136,468.80; compensation may vary based on qualifications, experience, location, market conditions, and business needs. Additional compensation may be available, including shift differentials, on-call pay, shift premiums, extra-shift incentives, or bonuses.

Requirements

Registered Nurse licensure is required.
At least 3 years of nursing experience is required.
Strong oral, written, and interpersonal communication skills.
Problem-solving, facilitation, and analytical skills.
Ability to travel to the Danville, South Boston, Ringgold, Dry Fork, and Chatham areas for in-person face-to-face assessments.

Nice To Haves

Bachelor’s degree preferred; an associate degree is listed under education.
Managed care experience preferred.
Discharge planning experience preferred.

Responsibilities

Provide case management services within the scope of licensure.
Develop, monitor, evaluate, and revise member care plans to meet member needs and optimize health 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 of high-risk complications and coordinate care with members and their health care teams.
Manage chronic illnesses, co-morbidities, 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 permissible extra-contractual arrangements to support implementation of member care plans.
Interface with Medical Directors, Physician Advisors, and interdisciplinary teams regarding care-management treatment plans.
Present cases at case conferences for multidisciplinary review.
Ensure compliance with regulatory, accrediting, and company policies and procedures.
Assist with problem-solving provider, claims, or service issues as needed.
Address individualized patient needs, including 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
Paid family caregiver leave
Adoption, fertility, and surrogacy reimbursement up to $10,000
Emergency backup care
Long-term and short-term disability plans
Critical illness plans
Tuition assistance up to $5,250 per year
Discounted educational opportunities through Guild Education
Student debt pay down up to $10,000
Pet insurance
Legal resources plan
Annual discretionary bonus opportunity, subject to system and employee eligibility criteria