Integrated Care Manager/Registered Nurse (RN)
Join to apply for the Integrated Care Manager/Registered Nurse (RN) role at Sentara Health.
Overview
The position requires both in-person face-to-face assessments and remote telephonic assessments for the LTSS waiver population. Status: Full-time, permanent position (40 hours). Standard working hours: 8am to 5pm EST, Monday–Friday. Location: Applicants must reside in Williamsburg, Yorktown, Newport News, Hampton, VA and surrounding areas.
Primary responsibilities
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 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, comorbidities, and/or disabilities ensuring cost‑effective and efficient utilization of health benefits; conducts gaps 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, ensuring compliance with regulatory, accrediting, and company policies and procedures.
May assist in problem solving with provider, claims, or service issues.
Required qualifications
Registered Nurse (RN) License (Compact or Virginia) – required.
Associate or Bachelor’s Degree in Nursing – required.
3 years experience in nursing – required.
Preferred qualifications
Case management experience preferred.
Discharge planning experience preferred.
Managed care or health plan experience preferred.
Education
Bachelor’s Degree in Nursing preferred.
Certification / Licensure
Registered Nurse (RN) License (Compact or Virginia) – required.
Benefits
Medical, Dental, and Vision plans.
Adoption, Fertility, and Surrogacy Reimbursement up to $10,000.
Paid Time Off and Sick Leave.
Paid Parental & Family Caregiver Leave.
Emergency Backup Care.
Long‑Term, Short‑Term Disability, and Critical Illness plans.
Life Insurance.
401(k) / 403(b) with Employer Match.
Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education.
Student Debt Pay Down – $10,000.
Reimbursement for certifications and free access to CEUs and professional development.
Pet Insurance.
Legal Resources Plan.
Potential for an annual discretionary bonus, if criteria are met.
Equal Opportunity Employer
Sentara Health is an equal opportunity employer and proudly promotes diversity, inclusion, and belonging.
How to Apply
Visit www.sentaracareers.com and search for keyword JR-88757 .