Nurse Case Manager-NOVA, VA

Overview

Sentara Healthcare is hiring an Integrated Nurse Case Manager for Northern Virginia, VA. This is a Full Time position with day shift hours and offers great benefits.

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 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
• Affords assistance in implementing member care plans by facilitating authorizations/referrals within benefits structure or extra-contractual arrangements, as permissible
• Interacts 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
• Might assist in problem solving with provider, claims or service issues

Education and Certification/License

• Associates or Bachelors Degree in Nursing
• Certified/Licensed Registered Nurse License (RN) - Nursing License - Compact/Multi-State License required

Experience

• 3 years experience in Nursing
• Discharge planning experience preferred
• Managed Care experience preferred

Preferred

• Private duty nursing
• Knowledgeable with ventilators in a facility or home

Benefits

• Caring For Your Family and Your Career
• 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
• 401k/403B 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 complete CEUs and professional development
• Pet Insurance
• Legal Resources Plan
• Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.

Company Information

• Sentara Health is an equal opportunity employer
• 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.