Integrated Nurse Case Manager: JR-68738

Department and Name: OHCC – Government LTSS
Physical Location: Sentara Health Plans Roanoke – Remote
Employment Status: Temporary – Full-Time
Shift: First (Days)
Posted Date: November 29, 2024

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Award-winning: Sentara is a Virginia and Northeastern North Carolina based not-for-profit integrated healthcare provider that has been in business for over 131 years. Offering more than 500 sites of care including 12 hospitals, PACE (Elder Care), home health, hospice, medical groups, imaging services, therapy, outpatient surgery centers, and an 858,000 member health plan. The people of the communities that we serve have nominated Sentara “Employer of Choice” for over ten years. U.S. News and World Report has recognized Sentara as having the Best Hospitals for 15+ years. Sentara offers professional development and a continued employment philosophy!

When you join Sentara as a nurse, you’ll have the tools, technologies and training to advance your career. You’ll be welcomed as part of an interdisciplinary care team that offers some of the most highly respected healthcare service in the region. Moreover, we’ll value what you bring to our expanding system of opportunity.

Overview

Sentara Health is seeking a dedicated Integrated Nurse Case Manager for the Roanoke region.

This full-time, work-from-home position requires travel to conduct face-to-face home visits in the member’s home or other locations within the Roanoke region. Travel coverage includes Roanoke City, Salem, Vinton, Cave Spring, and surrounding areas.

As an RN Clinician, you will provide case management services within the scope of your licensure, focusing on developing, monitoring, evaluating, and revising care plans to meet the individual needs of our members. The primary goal is to optimize healthcare outcomes across the care continuum.

You will perform telephonic and in-person clinical assessments, identify members with high-risk complications, coordinate care with healthcare teams, and ensure the efficient use of healthcare resources.

Key Responsibilities:

Develop and implement individualized care plans for members to address their physical, behavioral, social, and long-term care needs.
Perform telephonic and face-to-face clinical assessments to identify, evaluate, and manage members’ needs.
Coordinate care for high-risk members, including those with chronic conditions, co-morbidities, or disabilities.
Manage care to ensure cost-effective and efficient utilization of health benefits, including conducting gap-in-care management for quality programs.
Facilitate authorizations, referrals, and care plan implementation within benefits and coverage structures.
Work closely with Medical Directors, Physician Advisors, and Interdisciplinary Teams to present and discuss case management treatment plans.
Ensure compliance with regulatory, accrediting, and company policies and procedures.
Assist with problem-solving related to provider, claims, or service issues as needed.

Required Qualification:

Registered Nurse License (RN) – Nursing License – Compact/Multi-State License required
BSN (Bachelor of Science in Nursing) preferred
Nursing experience, with a focus on case management, care coordination, or patient advocacy.
Experience in PDN(private Duty Nursing): Proven experience providing skilled nursing care to patients in private home settings, with a strong understanding of patient care plans, coordination, and individualized treatment.
Vent Dependent Patient care : Experience managing and caring for patients who are ventilator-dependent, including monitoring respiratory status, managing ventilation equipment, and coordinating with interdisciplinary teams to provide optimal care.
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 skills.
Ability to work independently and collaboratively in a remote, fast-paced environment.

About Sentara Health:

For over a decade, Modern Healthcare magazine has ranked Sentara Health among the nation’s top integrated healthcare systems. With more than 300 sites of care in Virginia and northeastern North Carolina—including 12 acute care hospitals—we are committed to growth, innovation, and patient safety.

Sentara Benefits:

Sentara Health offers employees comprehensive health & welfare and retirement benefits (401(k)/403(b) with employer match) designed with you and your family's well-being in mind. You have a variety of options for medical, dental and vision insurance, life insurance, disability, educational assistance, student loan repayment and voluntary benefits as well as Paid Time Off in the form of sick time, vacation time and paid parental leave

Keyword: Indeed, Talroo, LinkedIn

Sentara 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.

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