Integrated Nurse Case Manager
Integrated Nurse Case Manager
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$ 66830 - 111384
1 Vacancy
Job Description
City/State
Roanoke VAWork Shift
First (Days)Overview:
Sentara Health Plans is hiring a Nurse Case Manager for the Health Care Services Department.
This is a remote position however traveling to Nursing Facilities and Members Home is required in Roanoke and surrounding areas in Virginia.
Key Responsibilities:
- Develop and implement individualized care plans for members to address their physical behavioral social and longterm care needs.
- Perform facetoface clinical assessments to identify evaluate and manage members needs.
- Coordinate care for highrisk members including those with chronic conditions comorbidities or disabilities.
- Manage care to ensure costeffective and efficient utilization of health benefits including conducting gapincare management for quality programs.
- Facilitate authorizations referrals and care plan implementation within benefits and coverage structures.
- Work closely with Medical Directors Physician Advisors and Interdisciplinary Teams to present and discuss case management treatment plans.
- Ensure compliance with regulatory accrediting and company policies and procedures.
- Assist with problemsolving related to provider claims or service issues as needed.
Education:
- Associate or bachelors degree in nursing
Certification:
- RN License (Virginia/Compact)
Experience:
- Nursing experience 3 years required.
- Discharge planning experience preferred.
- Managed Care experience preferred.
- Strong knowledge of physical psychological sociocultural and cognitive patient needs.
- Excellent communication skills both oral and written as well as strong problemsolving and analytical skills.
- Ability to work independently and collaboratively in a remote fastpaced environment.
Keywords: Talroo Health nursing discharge planning managed care case management RN nurse health plan health care Monster
Legal Resources Plan
Colleagues have the opportunity to earn an annual discretionary bonus ifestablished system and employee eligibility criteria is met.
Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30000member workforce. Diversity inclusion and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
In support of our mission to improve health every day this is a tobaccofree environment.
For positions that are available as remote work Sentara Health employs associates in the following states:
Alabama Delaware Florida Georgia Idaho Indiana Kansas Louisiana Maine Maryland Minnesota Nebraska Nevada New Hampshire North Carolina North Dakota Ohio Oklahoma Pennsylvania South Carolina South Dakota Tennessee Texas Utah Virginia Washington West Virginia Wisconsin and Wyoming.
Required Experience:
Manager
Employment Type
Full-Time
