About this Integrated Care Manager- Eastern Shore role at Sentara Health
City/State
Newport News, VAWork Shift
First (Days)Overview:
Sentara Health is hiring an Integrated Case Manager, RN to support members across the Eastern Shore region, with a primary focus on Behavioral Health, Waiver Services, and Complex Care Management.
This is a remote position; however, candidates must reside on Virginia's Eastern Shore or within a reasonable commuting distance. Regular travel throughout the Eastern Shore is required to conduct in-home and community-based member visits. Travel may comprise approximately 50% to 75% of the workweek.
Position Overview
The Integrated Case Manager, RN is responsible for providing comprehensive case management services within the scope of nursing licensure, focusing on members with behavioral health needs, complex medical conditions, intellectual and developmental disabilities, and those receiving Medicaid waiver services. The Case Manager develops, implements, evaluates, and revises individualized care plans designed to improve health outcomes, promote independence, and enhance quality of life.
This role conducts telephonic and face-to-face assessments to identify, coordinate, and manage members' physical health, behavioral health, social determinants of health, long-term services and supports (LTSS), and community resource needs.
Key Responsibilities
- Perform comprehensive assessments of members with complex medical, behavioral health, and social needs.
- Manage a caseload consisting primarily of members enrolled in waiver programs, behavioral health programs, and complex care management initiatives.
- Develop and maintain individualized care plans that address physical health, behavioral health, long-term services and supports, and social service needs.
- Coordinate care with members, caregivers, providers, behavioral health professionals, community agencies, and interdisciplinary care teams.
- Identify members at risk for adverse outcomes and implement interventions to reduce avoidable hospitalizations and emergency department utilization.
- Facilitate access to waiver services, community resources, behavioral health treatment, and specialty care.
- Monitor member progress, close gaps in care, and support quality improvement initiatives.
- Present complex cases during interdisciplinary case conferences and collaborate with Medical Directors, Physician Advisors, Behavioral Health teams, and community partners.
- Assist with authorization, referral, and service coordination processes in accordance with benefit plans and regulatory requirements.
- Maintain compliance with all regulatory, accreditation, and organizational policies and procedures.
Qualifications
Education
- Associate Degree in Nursing required
- Bachelor's Degree in Nursing (BSN) preferred
Licensure
- Active Registered Nurse (RN) license required
Experience
- Minimum of three (3) years of clinical nursing experience required
- Experience in care management, case management, behavioral health, managed care, Medicaid populations, waiver services, or community-based care strongly preferred
- Experience working with individuals with complex medical, behavioral health, intellectual/developmental disability, or long-term care needs preferred
Benefits: Caring For Your Family and Your Career
• Medical, Dental, Vision plans
• Adoption, Fertility and Surrogacy Reimbursement up to $10,000
• Paid Time Off and Sick Leave
• Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long-Term, Short-Term Disability, and Critical Illness plans
• Life Insurance
• 401k/403B with Employer Match
• Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education
• Student Debt Pay Down – $10,000
•Pet Insurance
•Legal Resources Plan
•Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.
Sentara Health is an equal opportunity employer and 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.
In support of our mission “to improve health every day,” this is a tobacco-free environment.
For positions that are available as remote work, Sentara Health employs associates in the following states:
Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.
