Case Manager-DSNP
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Job Location:
Virginia Beach, VA - USA
Monthly Salary:
Not Disclosed
Posted on:
22 hours ago
Vacancies:
1 Vacancy
Job Summary
City/State
Virginia Beach VAWork Shift
First (Days)Overview:
Sentara Health Plansis hiring an Integrated Nurse Case Manager/RNfor DSNP in Virginia Beach VA!
The position requires both in-person face-to-face assessments and remote telephonic assessments for Dual Special Needs Plan (DSNP) in their homes or facilities in Virginia Beach VA!
Status: Full-timepermanent position (40 hours)
Standard working hours: 8am to 5pm EST M-F
Location: Applicants must reside in Virginia Beach VA!
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.
Education:
Bachelors Degree in Nursing preferred
Certification/Licensure
Registered Nurse (RN) License (Compact or Virginia) REQUIRED
Preferred qualifications:
3 years experience in Nursing REQUIRED
Case Management experience preferred
Discharge planning experience preferred
Managed Care or Health Plan experience preferred
Sentara Health Plans provides health plan coverage to close to one million members in Virginia. We offer a full suite of commercial products including employee-owned and employer-sponsored plans as well as Individual & Family Health Plans Employee Assistance Programs and plans serving Medicare and Medicaid enrollees.
Our quality provider network features a robust provider network including specialists primary care physicians and hospitals.
We offer programs to support members with chronic illnesses customized wellness programs and integrated clinical and behavioral health servicesall to help our members improve their health.
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!
To apply please go to and use the following as your Keyword Search: JR-90044
#Indeed
Talroo - Nursing
Care Coordination Case Management RN Case Manager Registered Nurse BSN ADN Nursing Virginia Beach VA Managed Care MCO Health Plan DSNP Dual Special Needs Plan
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.
