Integrated Case Manager

Job description

City/State Harrisonburg, VA Work Shift First (Days) Overview: Sentara Health in Harrisonburg VA is looking to hire an Integrated Case Manager, RN. This position will work with members under Sentara Health Plans who are both medically and behaviorally complex. This position requires both in-person/face-to-face assessments and remote telephonic assessments for members with Serious Mental Illnesses, Serious Emotional Disturbances (ages 2+) and Substance Abuse Disorders! Location: Applicants must be in Harrisonburg, area VA . Travel may include up to 90 minutes one way. The Integrated Case Manager is 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. Ensure compliance with regulatory, accrediting and company policies and procedures. May assist in problem solving with provider, claims or service issues. Demonstrates the minimum knowledge, skills and abilities to care for the individualized needs of the patient to include physical, psychological, socio-cultural, spiritual and cognitive needs as well as functional abilities including the need for diversified use of such practices. Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills Education: · Associates (required) · Bachelors (preferred) Certification: · Registered Nurse (required) Experience: · 3 years of nursing experience (required) · Managed care (preferred) · Discharge planning experience (preferred) Keywords: Talroo- Health, Case Management, Managed Care, Discharge Planning Benefits: Caring For Your Family and Your Career • 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 through Guild Education • Student Debt Pay Down – $10,000 •Pet Insurance •Legal Resources Plan •Colleagues have the opportunity to earn an annual discretionary bonus if established 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.