About the position
Sentara Health Plans is hiring an Integrated Nurse Case Manager/RN/Maternity/OBGYN for Central/Richmond, VA! This is a full-time, work-from-home position that requires travel to conduct face-to-face home visits in the member's home or other locations within the Central/Richmond, VA region. The position is a permanent role with standard working hours from 8am to 5pm EST, Monday to Friday. Applicants must reside in the Central/Richmond, VA region.
Responsibilities
• 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.
Requirements
• Registered Nurse (RN) license.
• Experience in case management, particularly in maternity or OBGYN settings.
• Ability to perform clinical assessments and develop care plans.
Nice-to-haves
• Experience with telephonic case management.
• Knowledge of health benefits and care coordination.
Benefits
• Sign-on bonus offer to qualified applicants.
• Professional development opportunities.
• Work-life benefits.