106444 - Integrated Case Manager - Registered Nurse

About the Role

The role entails working with patients who have complex medical needs, including chronic illnesses, co-morbidities, and disabilities. You will be responsible for managing care plans, ensuring cost-effective and efficient utilization of health benefits, and conducting gap in care management for quality programs.

Sentara Health is committed to providing high-quality patient care, and as an Integrated Case Manager, you will play a key role in achieving this goal. You will work in a collaborative environment with a team of healthcare professionals who share your passion for delivering exceptional patient care.

What You Will Do

• Develop, monitor, and evaluate care plans for patients with complex medical needs
• Conduct telephonic or face-to-face clinical assessments to identify high-risk complications
• Coordinate care with healthcare teams, including Medical Directors, Physician Advisors, and Inter-Disciplinary Teams
• Manage chronic illnesses, co-morbidities, and disabilities, ensuring cost-effective and efficient utilization of health benefits
• Conduct gap in care management for quality programs
• Ensure compliance with regulatory, accrediting, and company policies and procedures
• Present cases at case conferences for multidisciplinary focus
• Assist with the implementation of member care plans by facilitating authorizations/referrals within benefits structure or extra-contractual arrangements
• Interface with healthcare teams to resolve issues and improve patient care
• Develop and maintain relationships with patients, families, and healthcare providers

What We Are Looking For

• Registered Nurse with a minimum of 3 years of nursing experience
• Strong oral, written, and interpersonal communication skills
• Problem-solving skills, facilitation skills, and analytical skills
• Experience in managed care, discharge planning, and case management preferred
• Ability to work independently and as part of a team
• Strong organizational and time management skills
• Ability to travel to patient locations as required
• Associate's or Bachelor's degree in Nursing
• Certification in Case Management or a related field preferred

Nice to Have

• Experience with electronic medical records and healthcare software
• Knowledge of regulatory requirements and accreditation standards
• Certification in a specialty area, such as pediatrics or gerontology
• Bilingual or multilingual skills
• Experience working with diverse patient populations

Benefits and Perks

• Medical, Dental, Vision plans
• Adoption, Fertility, and Surrogacy Reimbursement up to
  0,000
• 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 –
  0,000
• Reimbursement for certifications and free access to complete CEUs and professional development

• Develop a strong understanding of case management principles and practices to stand out in this role
• Highlight your experience working with electronic medical records and healthcare software in your application
• Be prepared to discuss your experience working with diverse patient populations and your approach to culturally sensitive care
• Showcase your problem-solving skills by providing examples of times when you had to coordinate care and resolve issues
• Consider obtaining certification in Case Management or a related field to demonstrate your expertise
• Research Sentara Health's commitment to diversity and inclusiveness and be prepared to discuss how you can contribute to this mission