Nurse Case Manager Sentara Healthcare IncNurse Case ManagerVARemotePrimary responsibilities include: • Responsible for case management services within the scope of licensure; develops, monitors, evaluates, and revises the members care plan to meet the members 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 members 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. Education: Associates or Bachelors Degree in Nursing (Required) Certification/Licensure: Virginia or Compact RN License (Required) Experience: 3 years experience in Nursing (Required) Experience in Private Duty Nursing or NICU or Experience working with Ventilators (Required) Discharge planning experience (Preferred) Managed Care experience (Preferred).
SF Case Manager Providence Forge Moms In MotionSF Case Manager Providence ForgeProvidence Forge, VAYou’ll spend your days connecting with families, helping them navigate Virginia’s Medicaid Waiver programs (CCC+, CL & FIS, EPSDT), and making sure those you serve can live safe, healthy, and independent lives. If you’re compassionate, organized, and love the idea of making your community a better place—you’ll fit right in!