City/State
Fredericksburg VAWork Shift
First (Days)Overview:
Sentara Health in Fredericksburg VA is looking to hire an Integrated Case Manager RN.
This is a remote position; however candidates must reside in Fredericksburg and surrounding areas as travel is required.
The Integrated Case Manager is 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. Ensure 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:
Certification:
Experience:
Keywords: Talroo- Health Case Management Managed Care Discharge Planning
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
Sentara Health, is an integrated, not-for-profit health care delivery system in Virginia and North Carolina. Sentara improves health everyday.