Sentara Health is seeking a dedicated Nurse Case Manager for the Tidewater, VA 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 Tidewater,VA region. Travel coverage includes Suffolk, Chesapeake, Virginia Beach, Norfolk.The members will be predominantly in the above areas and possibly the Eastern Shore. 

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 requiredBSN (Bachelor of Science in Nursing)  preferredNursing experience, with a focus on case management, care coordination, or patient advocacy.RN Case Manager serving members in High Intensity Care Management must have one year of experience working directly with members who meet the below conditions:  Members receiving private duty nursing services; Life-sustaining ventilator dependent members; Vulnerable infant members, including those diagnosed with neonatal abstinence syndrome, classified as substance-exposed, or admitted to the NICU level 3. 

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