Integrated Nurse Case Manager/RN- Williamsburg/Newport News, VA! Job at Sentara
Sentara Healthcare Inc, Williamsburg, VA, United States, 23187
Sentara Health Plans is hiring an Integrated Nurse Case Manager/RN for Williamsburg/Newport News,VA!
Sign-on bonus offer to qualified applicants!
The position requires both in-person face-to-face assessments and remote telephonic assessments for high-risk pregnant members!
Status: Full-time, permanent position (40 hours)
Standard working hours: 8am to 5pm EST, M-F
Location: Applicants must reside in Williamsburg/Newport News or surrounding areas.
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.
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
Experience working with high-risk pregnant population preferred
To apply, please go to www.sentaracareers.com and use the following as your Keyword Search: JR-68498
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