Integrated Case Manager
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Job Location:
Virginia Beach, VA - USA
Monthly Salary:
Not Disclosed
Posted on:
30+ days ago
Vacancies:
1 Vacancy
Job Summary
City/State
Virginia Beach VAWork Shift
First (Days)Overview:
Sentara Health Plans is seeking a dynamic Integrated Care Manager RN!
Travel required- most in person patient and provider visits will be in Virginia Beach.
RN Clinician 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.
Demonstrates the minimum knowledge skills and abilities to care for the individualized needs of the patient to include physical psychological socio-cultural spiritual and cognitive needs as well as functional abilities including the need for diversified use of such practices. Requires strong oral written and interpersonal communication skills problem-solving skills facilitation skills and analytical skills
Education
Associates degree in nursing (Required)
BSN (Preferred)
Certification/Licensure
RN License (Required)
Experience
Three years of Nursing experience (Required)
Two years Managed Care experience (Preferred)
Previous experience with discharge (Preferred)
Benefits
Sentara offers an attractive array of full-time benefits to include Medical Dental Vision Paid Time Off Sick Tuition Reimbursement a 401k/403B 401a Performance Plus Bonus Career Advancement Opportunities Work Perks and more.
Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth.
Be a part of an excellent healthcare organization that cares about our People Quality Patient Safety Service and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve!
Keywords: ICM RN Case Management Talroo - Nursing
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 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.
Required Experience:
Manager
Key Skills
- Project Portfolio Management
- Motivational Interviewing
- HIPAA
- Computer Skills
- Intake Experience
- Lean Six Sigma
- Conflict Management
- Case Management
- Team Management
- Program Development
- Social Work
- Addiction Counseling
About Company
Sentara Health, is an integrated, not-for-profit health care delivery system in Virginia and North Carolina. Sentara improves health everyday.
