Integrated Nurse Case Manager /RN - Central VA- Farmville, Emporia, South Hill
Company: Sentara Health
Location: Norfolk
Posted on: February 16, 2025
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Job Description:
City/State
Norfolk, VA
Overview
Work Shift
First (Days) (United States of America)
Sentara Healthcare is currently hiring an Integrated Nurse Case
Manager!
This is aFull Timeposition with day shift hours and great
benefits!
The position requires both in person face-to-face assessments and
remote telephonic assessments in preferably in Central area
including Farmville, Emporia, South Hill. Can also be in the
Charlottesville area including South Boston, Danville, Rustburg,
Appomattox.
Preferred: Private duty nursing experience and knowledgeable with
ventilators in a facility or home
Job Requirements:
Primary responsibilities include:
Sentara Health Plans is the health insurance division of Sentara
Healthcare doing business as Optima Health and Virginia
Premier.
Sentara Health Plans provides health insurance coverage through a
full suite of commercial products including consumer-driven,
employee-owned and employer-sponsored plans, individual and family
health plans, employee assistance plans and plans serving Medicare
and Medicaid enrollees.
With more than 30 years' experience in the insurance business and
20 years' experience serving Medicaid populations, 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.
Benefits: Sentara offers an attractive array of full-time benefits
to include Medical, Dental, Vision, Paid Time Off, Sick, Tuition
Reimbursement, a 401k/403B , 401a, Performance Plus Bonus, Career
Advancement Opportunities, Work Perks and more.
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!
Job Summary
RN Clinician 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.
Requires an RN; BSN preferred
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
Qualifications:
ALD - Associate's Level Degree: Nursing, BLD - Bachelor's Level
Degree, BLD - Bachelor's Level Degree: Nursing
Registered Nurse (RN) Single State - Nursing License - North
Carolina, Registered Nurse (RN) Single State - Nursing License -
Virginia Department of Health Professionals (VADHP), Registered
Nurse License (RN) - Nursing License - Compact/Multi-State
License
Discharge Planning, Managed Care, Nursing
Skills
Communication, Complex Problem Solving, Critical Thinking, Judgment
and Decision Making, Microsoft Office, Service Orientation
Sentara Healthcare 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.
Per Clinical Laboratory Improvement Amendments (CLIA), some
clinical environments require proof of education; these regulations
are posted at ecfr.gov for further information. In an effort to
expedite this verification requirement, we encourage you to upload
your diploma or transcript at time of application.
In support of our mission "to improve health every day," this is a
tobacco-free environment.
Keywords: Sentara Health, Norfolk , Integrated Nurse Case Manager /RN - Central VA- Farmville, Emporia, South Hill, Healthcare , Norfolk, Virginia
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