Integrated Nurse Case Manager​/Registered Nurse; RN

Location & Work Shift

Fredericksburg, VA

First (Days)

Sentara Health Plans is hiring an Integrated Nurse Case Manager/RN in Fredericksburg, Locust Grove, VA and surrounding areas. The position requires both in-person face-to-face assessments and remote telephonic assessments for the LTSS waiver population.

Full-time, permanent (40 hours). Standard working hours: 8am to 5pm EST, M-F.

Location:

Applicants must reside in Fredericksburg, Locust Grove, VA and surrounding areas.

• Responsible for case management services within scope of licensure; develop, monitor, evaluate, and revise member’s care plan to meet member needs, with goal of optimizing member health care across the care continuum.
• Perform telephonic or face-to-face clinical assessments for identification, evaluation, coordination and management of member’s needs, including physical and behavioral health, social services and long-term services.
• Identify members for high-risk complications and coordinate care with member and healthcare team.
• Manage chronic illnesses, co-morbidities, and/or disabilities ensuring cost‑effective and efficient utilization of health benefits; conduct gap‑in‑care management for quality programs.
• Assist with implementation of member care plans by facilitating authorizations/referrals within benefits structure or extra‑contractual arrangements as permissible.
• Interface with Medical Directors, Physician Advisors and/or Inter‑Disciplinary Teams on care management treatment plans.
• Present cases at case conferences for multidisciplinary focus; ensure compliance with regulatory, accrediting and company policies and procedures.
• May assist in problem solving with provider, claims or service issues.

• Registered Nurse (RN) License (Compact or Virginia)
  REQUIRED
  .
• Associate or Bachelor’s Degree in Nursing REQUIRED
  .
• 3 years experience in Nursing REQUIRED
  .

• Case Management experience preferred
  .
• Discharge planning experience preferred
  .
• Managed Care or Health Plan experience preferred
  .
• Bachelor’s Degree in Nursing preferred
  .

• Medical, Dental, Vision plans
• Adoption, Fertility and Surrogacy Reimbursement up to $10,000
• 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
• Student Debt Pay Down – $10,000
• Reimbursement for certifications and free access to CEUs and professional development
• Pet Insurance
• Legal Resources Plan
• Annual discretionary bonus opportunity (if established system and employee eligibility criteria met)

Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its workforce.

For positions available as remote work, Sentara Health employs associates in the following states:
Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

In support of our mission “to improve health every day,” this is a tobacco‑free environment.