Integrated Case Manager- RN
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At a glance
Requirements
Credentials this posting asks for.
Job overview
Sentara Health is hiring an Integrated Case Manager- RN. The Integrated Case Manager, RN, provides case management services within the scope of licensure, developing, monitoring, evaluating, and revising member care plans to optimize health care across the continuum. This role involves telephonic clinical assessments for identifying, evaluating, coordinating, and managing member needs, including physical and behavioral health, social services, and long-term services. The manager also identifies members with high-risk complications and coordinates care with the member and healthcare team.
Key focus areas include Develop, monitor, evaluate, and revise member's care plan, Perform telephonic clinical assessments for identification, evaluation, coordination and management of member's needs, and Identify members for high-risk complications.
Successful candidates bring Associates Degree, Registered Nurse, and 3 Years Nursing Experience. Important skills include Case Management, Telephonic Clinical Assessments, Care Coordination, Chronic Illness Management, Co-morbidities Management, and Disabilities Management.
Skills & qualifications
Skills
Qualifications
Benefits
Full job description
City/State
Winchester, VA
Work Shift
First (Days)
Overview:
Sentara Health is looking to hire an Integrated Case Manager, RN.
Status: Full Time (40 hrs/wk)
Shift: Day (8am-5pm)
This Position is remote but does require in person face-to-face assessments . Candidates must be able to travel to Winchester, Leesburg, Alexandria, Arlington, Manassas, Warrenton, Front Royal, Harrisonburg ,VA
The Integrated Case Manager is responsible for case management services within the scope of licensure; develops, monitors, evaluates, and revises the member's care plan to meet the member's needs, with the goal of optimizing member health care across the care continuum. Performs telephonic clinical assessments for the identification, evaluation, coordination and management of member's 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:
- Associates
- Bachelors preferred
Certification:
- Registered Nurse required
Experience:
- 3 years of nursing experience required
- Managed care preferred
- Discharge planning experience preferred
Keywords: Talroo- Health, Case Management, Managed Care, Discharge Planning
Benefits: Caring For Your Family and Your Career • Medical, Dental, Vision plans • Adoption, Fertility and Surrogacy Reimbursement up to $10,000 • Paid Time Off and Sick Leave • Paid Parental & Family Caregiver Leave • Emergency Backup Care • Long-Term, Short-Term Disability, and Critical Illness plans • Life Insurance • 401k/403B with Employer Match • Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education • Student Debt Pay Down – $10,000 • Reimbursement for certifications and free access to complete CEUs and professional development •Pet Insurance •Legal Resources Plan •Colleagues have the opportunity to earn an annual discretionary bonus if established 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 30,000-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.
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