Sentara Healthcare is currently hiring an Integrated Nurse Case Manager for Roanoke, VA location. This is a Full Time position with day shift hours and great benefits. The position requires both in person face-to-face assessments and remote telephonic assessments in and around Cana, Hillsville, Independence, Fries, Troutdale, Fancy Gap, Mouth of Wilson, and surrounding communities. Applicants must reside in Atkins, Wytheville, Marion, Chilhowie, Saltville, Rural Retreat, and Fort Chiswell area. Primary responsibilities include case management services within the scope of licensure; developing, monitoring, evaluating, and revising 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. Preferred: Private duty nursing experience and knowledgeable with ventilators in a facility or home. Education required: Associates or Bachelors Degree in Nursing. Certification/Licensure: Registered Nurse License (RN) - Nursing License - Compact/Multi-State License required. Experience: 3 years experience in Nursing. Discharge planning experience preferred. Managed Care experience preferred. Preferred: Private duty nursing and knowledgeable with ventilators in a facility or home.
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