What are the responsibilities and job description for the Integrated Case Manager- RN (Chesapeake) position at Sentara Health?
Sentara Health is looking to hire an Integrated Case Manager, RN.
This is a remote position; however, candidates must reside in Suffolk, Norfolk, VA Beach, Portsmouth, VA and the surrounding areas as travel is required up to 1 hour to see members approximately 50 to 75% a week.
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 Degree 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