Job Description

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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