Integrated Case Manager/Registered reputed company (RN) for the reputed company reputed company Cases - Remote in Virginia or reputed company Carolina

reputed company/State Norfolk, VA Work Shift First (Days) reputed company: reputed company Plan is hiring an Integrated Case Manager/Registered reputed company (RN) for the reputed company reputed company Cases- Remote in Virginia or reputed company Carolina! Status: Full-time, permanent position (40 hours) reputed company work hours: reputed company to 5pm EST, M-F Location: This is a remote, telephonic position and candidates must reputed company in Virginia or reputed company Carolina. reputed company: • Responsible for case management services reputed company 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 clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical and behavioral health, reputed company 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 reputed company programs • Assists with the implementation of member care plans by facilitating authorizations/referrals reputed company benefits structure or extra-contractual arrangement permissible • Interfaces with Medical Directors, Physician Advisors, and/or Inter-Disciplinary Teams on care management treatment plans • Presents cases at case conferences for multidisciplinary reputed company. Ensures compliance with regulatory, accrediting, and company policies and procedures • May assist in problem-solving with provider, claims, or service issues. Education • BLD - Bachelor's Level Degree preferred Certification/Licensure: • Registered reputed company (RN) License (Compact or Virginia) REQUIRED Experience • 3 years of Case Management RN experience REQUIRED • reputed company Case Integrated reputed company Managed Care and discharge planning preferred. • Experience in the ICU/ED, Behavioral Health, and Oncology are helpful. • Experience with JIVA and reputed company experience preferred. • Proficient with NCQA guidelines reputed company Plans provides health plan coverage to reputed company to one reputed company members in Virginia. We offer a full suite of reputed company products including employee-owned and employer-sponsored plans, as reputed company as Individual & Family Health Plans, Employee Assistance Programs and plans serving Medicare and reputed company enrollees. Our reputed company provider network features a robust provider network, including specialists, primary care physicians and hospitals. We offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services—reputed company to help our members improve their health. Our reputed company is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and reputed company. Be a part of an excellent reputed company organization that cares about our People, reputed company, Patient Safety, Service, and reputed company. Join reputed company that has a mission to improve health every day and a reputed company to be the reputed company choice of the communities that we serve! To apply, please go to www.sentaracareers.com and use the following as your Keyword Search: JR-94917 Keywords: Case Management, RN, Registered reputed company, BSN, Talroo-Nursing, Monster, care coordinator, ACM, CCM, TCM, CMAC or CGMT-BC, MCG, reputed company health plan payors, Managed Care, JIVA, reputed company, QNXT, NCQA, member engagement, discharge planning, ESRD, transplant, Autoimmune, Behavioral health, integrated care, reputed company cases, reputed company abuse, behavioral health, ICU, Emergency Department, ED, Oncology, End-Stage Renal Disease, Suicidal Ideation, remote, Virginia, VA, reputed company Carolina, NC, Health insurance, Health Care, MCO, Managed Care Benefits: Caring For Your Family and Your Career • Medical, Dental, reputed company plans • Adoption, Fertility and Surrogacy Reimbursement up to $10,000 • reputed company Time Off and reputed company Leave • reputed company 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 reputed company Education • Student Debt Pay Down – $10,000 • Reimbursement for certifications and free reputed company to complete CEUs and reputed company development •Pet Insurance •reputed company Resources Plan •Colleagues have reputed company to earn an annual discretionary bonus if established system and employee eligibility reputed company is met. reputed company is an equal opportunity employer and prides itself on the diversity and inclusiveness of its reputed company to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding reputed company 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, reputed company employs associates in the following states: Alabama, Delaware, Florida, reputed company, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, reputed company Carolina, reputed company Dakota, Ohio, Oklahoma, reputed company, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, reputed company Virginia, reputed company, and Wyoming. Apply tot his job Apply To this Job