Sentara Healthcare is currently hiring an Integrated Nurse Case Manager for Central Virginia Region!

This is a Full Time position with day shift hours and great benefits!

Requires travel to conduct face-to-face home visits in the member’s home or other locations within the Central Region -Fredericksburg, Stafford, Spotsylvania, Caroline County, King George, Westmoreland, King William, Hanover, Goochland, Henrico, Richmond City, etc . The members will be predominantly in the above areas and possibly in Charlottesville Region (Locust Grove/Orange County, Louisa) & Northern VA Region (Prince William, Culpeper, Fauquier, Rappahannock)

Primary responsibilities include:

• 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 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

• 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

Preferred: Private duty nursing experience and knowledgeable with ventilators in a facility or home

Education

• Associates or Bachelors Degree in Nursing

Certification/Licensure

• Registered Nurse License (RN) – Nursing License – Compact/Multi-State License required.

Experience

• 3 years experience in Nursing

• Discharge planning experience preferred

• Managed Care experience preferred

• Preferred: Private duty nursing and knowledgeable with ventilators in a facility or home

Keywords: Care Coordination, Case Management, Human Services, Community Health, Health Education, RN Case Manager, Registered Nurse, BSN, ADN, Private Duty, Ventilator, LinkedIn, Talroo-Nursing