Sentara Health
City/State
Lexington, VA Work Shift
First (Days) Overview: Sentara Health Plansis hiring an Integrated Nurse Case Manager/RN/Maternity/OBGYN for Lexington, Buena Vista, Millboro, Goshen, Warm Springs, McDowell and surrounding areas! This is a full-time, work-from-homeposition that requires travel to conduct face-to-face home visits for low and high risk pregnant population/ member's homes or other locations in Lexington, Buena Vista, Millboro, Goshen, Warm Springs, McDowell and surrounding areas! Status: Full-time,permanent position (40 hours) Standard working hours: 8am to 5pm EST, M-F Location: Applicants must be reside in Lexi ngton, Buena Vista, Millboro, Goshen, Warm Springs, McDowell and surrounding areas!! Primary responsibilities include:
•Legal Resources Plan
•Colleagues have the opportunity to earn an annual discretionary bonus ifestablished system and employee eligibility criteria is met. Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. In support of our mission “to improve health every day,” this is a tobacco-free environment. For positions that are 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.
Lexington, VA Work Shift
First (Days) Overview: Sentara Health Plansis hiring an Integrated Nurse Case Manager/RN/Maternity/OBGYN for Lexington, Buena Vista, Millboro, Goshen, Warm Springs, McDowell and surrounding areas! This is a full-time, work-from-homeposition that requires travel to conduct face-to-face home visits for low and high risk pregnant population/ member's homes or other locations in Lexington, Buena Vista, Millboro, Goshen, Warm Springs, McDowell and surrounding areas! Status: Full-time,permanent position (40 hours) Standard working hours: 8am to 5pm EST, M-F Location: Applicants must be reside in Lexi ngton, Buena Vista, Millboro, Goshen, Warm Springs, McDowell and surrounding areas!! 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.
- Associate or Bachelors Degree in Nursing REQUIRED
- Registered Nurse (RN) License (Compact or Virginia) REQUIRED
- 3 years experience in Nursing REQUIRED
- Case Management experience preferred
- Managed Care or Health Plan experience preferred
- Experience working with low and high risk pregnant population/Maternity/OB/L&D/Mother Baby/Postpartum experience preferred
- Strong knowledge of physical, psychological, socio-cultural, and cognitive patient needs.
- Excellent communication skills, both oral and written, as well as strong problem-solving and analytical
•Legal Resources Plan
•Colleagues have the opportunity to earn an annual discretionary bonus ifestablished system and employee eligibility criteria is met. Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. In support of our mission “to improve health every day,” this is a tobacco-free environment. For positions that are 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.