NURSE CASE MGR

Sentara Healthcare is currently hiring an Integrated Nurse Case Manager for Central Virginia Region! This is a Full Time position with day shift hours and great benefits! Requires travel to conduct face-to-face home visits in the member’s home or other locations within the Central Region -Fredericksburg, Stafford, Spotsylvania, Caroline County, King George, Westmoreland, King William, Hanover, Goochland, Henrico, Richmond City, etc . The members will be predominantly in the above areas and possibly in Charlottesville Region (Locust Grove/Orange County, Louisa) & Northern VA Region (Prince William, Culpeper, Fauquier, Rappahannock) 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 Preferred: Private duty nursing experience and knowledgeable with ventilators in a facility or home Education • Associates or Bachelors Degree in Nursing Certification/Licensure • 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 and knowledgeable with ventilators in a facility or home Keywords: Care Coordination, Case Management, Human Services, Community Health, Health Education, RN Case Manager, Registered Nurse, BSN, ADN, Private Duty, Ventilator, LinkedIn, Talroo-Nursing Apply tot his job Apply To this Job