City/State

Work Shift

Overview:

Sentara Healthcare is currently hiring an Integrated RN Case Manager for the Virginia Beach/Norfolk VA market.

This is aFull-Timeposition with day shift hours and great benefits!

The position requires both in-person face-to-face assessments and remote telephonic assessments in and around Virginia Beach Norfolk and surrounding communities.

*Applicants must reside within driving distance.

Primary responsibilities include:

• Responsible for case management services within the scope of licensure; develops monitors evaluates and revises the members care plan to meet the members 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 members 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

Preferred: LTSS Medicaid waiver population case management experience and knowledge of DMAS and Epic

Education

• Associates or Bachelors Degree in Nursing

Certification/Licensure

• Registered Nurse License (RN) - Nursing License - Compact/Multi-State License required.

Experience

• 3 years experience in Nursing

• Discharge planning experience preferred

• Managed Care experience preferred

• Preferred: LTSS Medicaid waiver population case management experience and knowledge of DMAS and Epic

Keywords: Care Coordination Case Management Human Services Community Health Health Education RN Case Manager Registered Nurse BSN LinkedIn Monster Talroo-Nursing Cardinal Medicaid DMAS MCO managed care LTSS long-term services support transition of care discharge planning community outreach

Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30000-member 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 tobacco-free 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.