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Nurse Case Mgr Jobs

Company

Sentara Healthcare

Address , Norfolk, 23502
Employment type FULL_TIME
Salary
Expires 2023-12-02
Posted at 9 months ago
Job Description

Sentara Health Plans is currently seeking a full-time, Nurse Case Manager

This position is remote in the Northern Virginia Region and requires face-to-face visits with members and telephonic assessments.

RN Clinician 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.

Demonstrates the minimum knowledge, skills, and abilities to care for the individualized needs of the patient to include physical, psychological, socio-cultural, spiritual, and cognitive needs as well as functional abilities including the need for diversified use of such practices. Requires strong oral, written, and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

Job Requirements:

  • Discharge planning experience preferred
  • Managed Care experience preferred
  • Associates or Bachelor’s Degree in Nursing
  • Nursing experience 3 years required
  • RN License (Virginia/Compact)

Sentara Health Plans is the health insurance division of Sentara Healthcare doing business as Optima Health and Virginia Premier.

Sentara Health Plans provides health insurance coverage through a full suite of commercial products including consumer-driven, employee-owned and employer-sponsored plans, individual and family health plans, employee assistance plans and plans serving Medicare and Medicaid enrollees.

With more than 30 years’ experience in the insurance business and 20 years’ experience serving Medicaid populations, we offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services – all to help our members improve their health.

Benefits: Sentara offers an attractive array of full-time benefits to include Medical, Dental, Vision, Paid Time Off, Sick, Tuition Reimbursement, a 401k/403B, 401a, Performance Plus Bonus, Career Advancement Opportunities, Work Perks and more.

Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth.

Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve!

Keywords: nursing, discharge planning, managed care, case management, RN, nurse, health plan, health care, Indeed, Monster

RN Clinician 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. Requires an RN; BSN preferred Demonstrates the minimum knowledge, skills and abilities to care for the individualized needs of the patient to include physical, psychological, socio-cultural, spiritual and cognitive needs as well as functional abilities including the need for diversified use of such practices. Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills
  • Registered Nurse License (RN) - Virginia
  • Registered Nurse License (RN) - North Carolina
  • Registered Nurse License (RN) - Compact/Multi-State License
  • Bachelor's Level Degree
  • Associate's Level Degree
  • Bachelor's Level Degree
  • Discharge Planning Previous Experience
  • Managed Care 2 years
  • Nursing 3 years
  • Complex Problem Solving
  • Judgment and Decision Making
  • Microsoft Office
  • Service Orientation
  • Critical Thinking
  • Communication