NURSE CASE MGR

City / State

Richmond, VA

Work Shift

First (Days)

Overview :

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

This is aFull Timeposition with day shift hours and great benefits!

R equires 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

Certification / Licensure

Experience

Benefits : Caring For Your Family and Your Career

Medical, Dental, Vision plans

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.