Job Title

Sentara Healthcare is currently hiring an Integrated Nurse Case Manager for South West Virginia RegionThis is a Full Time position with day shift hours and great benefitsRequires travel to conduct face-to-face home visits in the member's home or other locations within the south west region of VA (Wise county, Lee county, Scott county, Dickenson county, Russel county, Washington county, Bristol) . 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 continuumPerforms 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 servicesIdentifies members for high-risk complications and coordinates care in conjunction with the member and health care teamManages chronic illnesses, co-morbidities, and/or disabilities ensuring cost effective and efficient utilization of health benefits; conducts gap in care management for quality programsAssists with the implementation of member care plans by facilitating authorizations/referrals within benefits structure or extra-contractual arrangements, as permissibleInterfaces with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on care management treatment plansPresents cases at case conferences for multidisciplinary focus. Ensures compliance with regulatory, accrediting and company policies and proceduresMay assist in problem solving with provider, claims or service issuesPreferred: Private duty nursing experience and knowledgeable with ventilators in a facility or homeEducationAssociates or Bachelors Degree in NursingCertification/LicensureRegistered Nurse License (RN) - Nursing License - Compact/Multi-State License required.Experience3 years experience in NursingDischarge planning experience preferredManaged Care experience preferredPreferred: Private duty nursing and knowledgeable with ventilators in a facility or home Care Coordination, Case Management, Human Services, Community Health, Health Education, RN Case Manager, Registered Nurse, BSN, ADN, Private Duty, Ventilator, LinkedIn, Talroo-Nursing