Integrated Nurse Case ManagerRegistered NurseRN for ChronicComplex Condition- Virginia Beach, Norfolk
Share
Job Location:
Virginia Beach, VA - USA
Monthly Salary:
Not Disclosed
Posted on:
18 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/Registered Nurse/RN for Chronic/Complex Condition in Virginia Beach Norfolk VA and the surrounding areas!
This is a full-time work-from-homeposition that requires travel to conduct face-to-face home visits for chronic/complex condition members (asthma diabetes heart failure cancer heart disease COPD) Virginia Beach Norfolk VA and the surrounding areas!
Status: Full-timepermanent position (40 hours)
Standard working hours: 8am to 5pm EST M-F
Location: Applicants must reside in Virginia Beach Norfolk VA and the surrounding areas!
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.
Target Member Population Includes:
High Emergency Room (ER) utilizers
Recent hospital discharges
Members diagnosed with heart failure COPD asthma or diabetes
Education:
Associate or Bachelors Degree in Nursing REQUIRED
Certification/Licensure:
Registered Nurse (RN) License (Compact or Virginia) REQUIRED
Experience:
3 years experience in Nursing REQUIRED
Case Management experience preferred
Managed Care or Health Plan experience preferred
Experience working with chronic/complex condition members (Asthma diabetes heart failure cancer heart disease COPD) home health experience inpatient case management experience hospice experience preferred
Strong knowledge of physical psychological socio-cultural and cognitive patient needs.
Excellent communication skills both oral and written as well as strong problem-solving and analytical
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-94794
Talroo Health Plan
Managed Care MCO Health Plan Healthcare Health Insurance Nursing RN Registered Nurse Medicaid Chronic Complex condition members Asthma diabetes heart failure cancer heart disease COPD home health experience inpatient case management hospice emergency room ED Virginia Beach Norfolk VA Remote Virginia
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
- EMR Systems
- Hospital Experience
- Acute Care
- ICU Experience
- Hospice Care
- Workers' Compensation Law
- Home Care
- Nursing
- Catheterization
- Critical Care Experience
- Medication Administration
- Tube Feeding
About Company
Sentara Health, is an integrated, not-for-profit health care delivery system in Virginia and North Carolina. Sentara improves health everyday.
