Overview Sentara Health Plans is currently hiring an Integrated Nurse Case Manager in Tidewater, Virginia. This remote position requires frequent in?person assessments across several locations in the Tidewater region.
Location & Travel Remote (requires frequent travel). Assessment locations include Virginia Beach, Chesapeake, Norfolk, Suffolk, Portsmouth, and occasionally Hampton, Newport News, and Williamsburg.
Job Type & Schedule Full Time (40 hrs/week). Shift: Day (8am?5pm). First (Days).
Primary Responsibilities
Provide case management services within scope of licensure; develop, monitor, and revise member care plans to optimize health outcomes.
Conduct telephonic or face?to?face clinical assessments to evaluate and coordinate physical, behavioral, and social health needs.
Identify high?risk members and coordinate care with the member and health care team.
Manage chronic illnesses and co?morbidities to ensure cost?effective utilization of health benefits.
Assist in implementing member care plans with authorizations/referrals as permitted.
Collaborate with Medical Directors, Physician Advisors, and interdisciplinary teams on treatment plans.
Present cases at multidisciplinary conferences and maintain compliance with regulatory and company policies.
Support problem?solving with providers, claims, or service issues as needed.
Preferred Qualifications Private duty nursing experience, especially with ventilator management in a facility or home setting.
Education Associates or Bachelors Degree in Nursing (required).
Licensure & Certification Virginia or Compact RN License (required).
Experience Minimum 3 years of nursing experience.
Experience in private duty nursing, NICU, or working with ventilated patients (required).
Discharge planning experience (preferred).
Managed care experience (preferred).
Benefits Medical, Dental, 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
Keywords Care Coordination, Case Management, Human Services, Community Health, Health Education, RN Case Manager, Registered Nurse, BSN, ADN, Private Duty, Ventilator, LinkedIn, Talroo?Nursing
Equal Opportunity Employer Sentara Health is an equal?opportunity employer and proudly embraces diversity, inclusion, and belonging. The workforce strives to reflect the communities served. We maintain a tobacco?free environment and support the mission to improve health every day.
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