Integrated Nurse Care Manager
Sentara Health Plans Richmond - Remote, United States
City/State
Richmond, VAWork Shift
First (Days)Overview:
Sentara Healthcare is currently hiring an Integrated Nurse Case Manager- Central/South-Central Virginia region
This is a Full Time position with day shift hours and great benefits!
The position requires travel to conduct face-to-face home visits in the member’s home within the Central/South-Central Virginia region
This position is based in Virginia’s Central/South-Central region, including but not limited to: Lynchburg, Boonsboro, Madison Heights, Bedford, Evington, and Rustburg
Applicants must reside in or near one of these locations to be considered for the role.
The Integrated Care Manager (ICM) is a Registered Nurse Clinician responsible for providing comprehensive case management services to a defined high-risk member population. This role focuses on supporting individuals with complex care needs and aims to optimize health outcomes through proactive coordination, care planning, and resource management across the care continuum.
Target Member Population Includes:
High Emergency Room (ER) utilizers
Recent hospital discharges
Members diagnosed with heart failure, COPD, or diabetes
Individuals with Developmental Disability (DD) waivers
Key Responsibilities:
Perform telephonic and/or face-to-face clinical assessments to identify, evaluate, and manage member needs, including medical, behavioral health, social, and long-term care services
Develop, monitor, evaluate, and revise individualized care plans tailored to member needs and health goals
Identify members at risk for complications or re-hospitalizations and coordinate timely interventions with the member, caregiver, and health care team
Support management of chronic illnesses, co-morbidities, and disabilities, ensuring appropriate utilization of benefits and adherence to care plans
Conduct gap in care management as part of quality improvement initiatives
Facilitate necessary authorizations and referrals within benefit guidelines or through extra-contractual arrangements when appropriate
Collaborate with Medical Directors, Physician Advisors, and Interdisciplinary Teams to review and align on care plans and treatment recommendations
Present member cases in case conferences to ensure a multidisciplinary approach to care
Ensure all activities are compliant with regulatory standards, accreditation requirements, and company policies
Assist in resolving provider, claims, or service-related issues impacting member care
Associates or Bachelors Degree in Nursing
- Registered Nurse License (RN) - Nursing License - Compact/Multi-State License required.
3 years experience in Nursing
Strong background in case management, including the ability to develop, monitor, and revise individualized care plans for complex member populations.
Experience working with high-risk members, such as those with: Frequent ER utilization / Recent hospital discharges / Chronic conditions (e.g., heart failure, COPD, diabetes)/ Individuals with Developmental Disability (DD) waivers.
Ability to collaborate with interdisciplinary teams, including physicians, social workers, and behavioral health professionals
Excellent communication, critical thinking, and organizational skills
Demonstrated flexibility and adaptability in a field-based role with travel requirements
Keywords: Care Coordination, Case Management, Human Services, Community Health, Health Education, RN Case Manager, , #INDEED, #ZipRecruiter, LinkedIn, Talroo-Nursing, ER utilization , discharges, heart failure, COPD, diabetes), Developmental Disability (DD) waivers.
We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits. The base pay rate for Full Time employment is:$66,830.40-$111,384.00Additional compensation may be available for this role such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.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• Reimbursement for certifications and free access to complete CEUs and professional development•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.
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Alabama Delaware Florida Georgia Idaho Indiana Kansas Louisiana Maine Maryland Minnesota Must reside in or near specified locations Nebraska Nevada New Hampshire North Carolina North Dakota Ohio Oklahoma Pennsylvania Remote South Carolina South Dakota Tennessee Texas Utah Virginia West Virginia Wisconsin Wyoming
Benefits/Perks401k/403b 401k/403b with employer match 403b Annual discretionary bonus Bonus opportunities Dental Development Disability Emergency backup care Great benefits Healthcare Incentives Legal resources Life Insurance Market-competitive compensation Medical Paid Time Off Pet Insurance Professional development Remote work Sick Leave Student debt pay down Tuition Assistance Vision Vision plans
Tasks- Case management services
- Collaborate with healthcare teams
- Conduct clinical assessments
- Coordinate interventions
- Develop care plans
- Ensure compliance with standards
- Manage chronic illnesses
Accreditation Behavioral health Care Coordination Care management Case Management Clinical assessments Communication Coordinate Coordination Critical thinking Healthcare Health education Interdisciplinary Collaboration IT Management Nursing Organizational Quality improvement Reimbursement RN Support
Experience3 years
EducationAssociates Associate's Degree Bachelor's degree Nursing RN
CertificationsCompact nursing license Registered Nurse License RN
TimezonesAmerica/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9