First (Days) (United States of America)
Sentara Healthcare is currently hiring an Integrated Care Management Team Coordinator for our Disease Management team!
This is a Full Time position with day shift hours and great benefits!
This position is a remote hybrid requiring some days on site at our Virginia Beach office.
Applicants must be located in Hampton Roads, Virginia or surrounding area
- RN License (Virginia)
- Bachelors Degree in Nursing
- Minimum 3 years experience in Case Management
- Supervisory experience
- Experience in Chronic Disease Management
- Program Development experience
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.
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: Care Coordination, Case Management, Human Services, Community Health, Health Education, RN Case Manager, Registered Nurse, BSN, Commerical Managed Care, Disease management, Chronic Disease, Program Development
Assumes responsibility, accountability and leadership for the daily operations including coordination of work, quality, and service. First line supervisor in the Department of Medical Care Management for assigned site/function. Facilitates the work of assigned team members. Provides a leadership role in ongoing case manager competency assessment, needs identification and educational offerings. Provides educational services to the Medical Care Management staff . Participates in the work activities of assigned teams and provides case management services as needed.
N-4YR – RN-Bachelor’s Level Degree (Required)
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