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Award-winning: Sentara is a Virginia and Northeastern North Carolina based not-for-profit integrated healthcare provider that has been in business for over 131 years. Offering more than 500 sites of care including 12 hospitals, PACE (Elder Care), home health, hospice, medical groups, imaging services, therapy, outpatient surgery centers, and an 858,000 member health plan. The people of the communities that we serve have nominated Sentara “Employer of Choice” for over ten years. U.S. News and World Report has recognized Sentara as having the Best Hospitals for 15+ years. Sentara offers professional development and a continued employment philosophy!
Sentara Health Plans is hiring an Integrated Nurse Case Manager/Registered Nurse (RN) for Norfolk, VA Beach, Suffolk, Chesapeake, Portsmouth, VA!
Sign-on bonus offer to qualified applicants!
The position requires both in-person face-to-face assessments and remote telephonic assessments for the waiver population.
Status: Full-time, permanent position (40 hours)
Standard working hours: 8am to 5pm EST, M-F
Location: Applicants must reside in Norfolk, VA Beach, Suffolk, Chesapeake, Portsmouth, VA!
Primary responsibilities include:
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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
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Performs telephonic or face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical and behavioral health, social services and long-term services
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Identifies members for high-risk complications and coordinates care in conjunction with the member and health care team
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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
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Assists with the implementation of member care plans by facilitating authorizations/referrals within benefits structure or extra-contractual arrangements, as permissible
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Interfaces with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on care management treatment plans
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Presents cases at case conferences for multidisciplinary focus. Ensures compliance with regulatory, accrediting and company policies and procedures
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May assist in problem solving with provider, claims or service issues.
Required qualifications:
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Registered Nurse (RN) License (Compact or Virginia) REQUIRED
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Associate or Bachelors Degree in Nursing REQUIRED
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3 years experience in Nursing REQUIRED
Preferred qualifications:
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Case Management experience preferred
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Discharge planning experience preferred
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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 services—all 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 www.sentaracareers.com and use the following as your Keyword Search: JR-77797
Talroo – Nursing
Care Coordination, Case Management, RN, Case Manager, Registered Nurse, BSN, ADN, Nursing, Norfolk, VA Beach, Suffolk, Chesapeake, Portsmouth, Tidewater, Managed Care, MCO, Health Plan
Culture In Action
At Sentara, our differences are our strengths. The unique backgrounds, skills, and experiences that each Sentara colleague brings to work are what make Sentara special and what allows us to deliver excellent service and care to our patients, members, and communities.
Sentara 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.
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