Perinatal in Central Richmond (Henrico, Hanover, Colonial Heights, VA)

Sentara Hospitals•Richmond, VA

1d•Hybrid

About The Position

Sentara Health Plans is hiring an Integrated Nurse Case Manager/RN for Maternal Health/ Perinatal for Central Richmond (Henrico, Hanover, Colonial Heights, VA and the surrounding areas)! The position requires both telephonic and face-to-face assessments and remote telephonic assessments for the low-risk and high-risk pregnant population (Maternal Health / Perinatal / OB-GYN /Labor and Delivery / Mother-Baby / Postpartum) in Central Richmond (Henrico, Hanover, Colonial Heights, VA) and the surrounding areas. This is a full-time, permanent position with standard working hours of 8am to 5pm EST, Monday through Friday. Applicants must reside in Central Richmond (Henrico, Hanover, Colonial Heights, VA) and the surrounding areas.

Requirements

Associate or Bachelors Degree in Nursing REQUIRED
Registered Nurse (RN) License (Compact or Virginia) REQUIRED
3 years experience in Nursing REQUIRED

Nice To Haves

Case Management experience preferred
Managed Care or Health Plan or Medicaid experience preferred
Experience working with low and high risk pregnant population (Maternal Health / Perinatal / OB-GYN /Labor and Delivery / Mother-Baby / Postpartum) experience preferred
Strong knowledge of physical, psychological, socio-cultural, and cognitive patient needs.
Excellent communication skills, both oral and written, as well as strong problem-solving and analytical skills

Responsibilities

Responsible for case management services within the scope of licensure; develops, monitors, evaluates, and revises the member's care plan to meet the member's needs, with the goal of optimizing member health care across the care continuum
Performs telephonic or face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical and behavioral health, social services and long-term services
Identifies members for high-risk complications and coordinates care in conjunction with the member and health care team
Manages chronic illnesses, co-morbidities, and/or 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 authorizations/referrals within benefits structure or extra-contractual arrangements, as permissible
Interfaces with Medical Directors, Physician Advisors and/or Inter-Disciplinary 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.

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
Annual discretionary bonus if established system and employee eligibility criteria is met.