Sentara Healthcare is currently hiring an Integrated RN Case Manager for the Charlottesville/Harrisonburg, VA market.

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

The position requires both in-person face-to-face assessments and remote telephonic assessments in and around Charlottesville, Harrisonburg, Danville, Lynchburg, Waynesboro, and surrounding communities.

*Applicants must reside within driving distance.

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: LTSS, Medicaid, waiver population case management experience, and knowledge of DMAS and Epic

Education

• Associate's 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: LTSS, Medicaid, waiver population case management experience, and knowledge of DMAS and Epic

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