• Job Description

  Req#: JR-96242

  City/State

  Norfolk, VA

  Work Shift

  First (Days)

  Overview:

  Sentara Health Plans is hiring for a Manager, Integrated Care Management/RN/LPC/LCSW/LCMHC for DSNP- Remote in Virginia!

  Status: Full-time, permanent position (40 hours)

  Standard working hours: 8am to 5pm EST, M-F

  Location: Remote in Virginia only with occasional onsite meetings in Virginia Beach, VA (1-2 times per year).

  Overview

  • Responsible for managing and coordinating the patient care transitions program.

  • This ensures the patient's progression through the care continuum in a manner that achieves designed clinical and financial outcomes.

  • Participates in the system development and implementation of integration of care transitions along the continuum of care.

  • Works in close collaboration with the multidisciplinary team, in all settings to include ambulatory, post - acute providers and health plans.

  • Serves as mentor by role modeling a professional practice consistent with organizational goals, customer service, clinical effectiveness, and standards of care.

  • Responsible for developing and managing the departmental budget, compliance to federal, state and regulatory requirements.

  • Manages the DSNP team with oversight of Medicare and Medicaid requirements

  • Oversees contractual compliance and NCQA requirements

  • Leads 5 direct reports (supervisors) and 66 indirect reports, including care coordinators, ICMs, and LCSWs, etc.

  Education

  • Bachelor’s Degree REQUIRED

  Certification/Licensure

  • One of the following is REQUIRED :

    • Registered Nurse License (RN) - Nursing License - Compact/Multi-State License or

    • Licensed Clinical Social Worker (LCSW) - State license - North Carolina Social Work Certification and Licensure Board (NCSWCLB) or

    • Qualified Mental Health Professional (QMHP) - State License - Virginia Department of Health Professionals (VADHP) or

    • Licensed Clinical Mental Health Counselor (LCMHC) - State License - North Carolina Board of Licensed Clinical Mental Health Counselors (NCBLCMHC) or

    • Licensed Professional Counselor (LPC) - State license - Virginia Department of Health Professionals (VADHP) or

    • Licensed Professional Counselor (LPC) - State license - North Carolina Board of Licensed Clinical Mental Health Counselors (NCBLCMHC)

  Experience

  • 3 years of case management experience REQUIRED

  • 1 year of leadership experience REQUIRED

  • With extensive Medicare/DSNP experience preferred

  • Has knowledge of LTSS Medicaid requirements

  • Has worked with State Medicaid Agency Contract (SMAC)

  Sentara Health Plans provides health plan coverage to close to one million members in Virginia. We offer a full suite of commercial products including employee-owned and employer-sponsored plans, as well as Individual & Family Health Plans, Employee Assistance Programs and plans serving Medicare and Medicaid enrollees.

  Our quality 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—all to help our members improve their health.

  Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth.

  Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve!

  To apply, please go to www.sentaracareers.com and use the following as your Keyword Search: JR-96242

  #Indeed

  Talroo - Nursing

  Care Coordination, Case Management, RN, Case Manager, Registered Nurse, BSN, Nursing, Managed Care, MCO, Health Plan, Virginia, Remote, Licensed Clinical Social Worker (LCSW) - State license - Virginia Department of Health Professionals (VADHP), Licensed Professional Counselor (LPC) - State license - Virginia Department of Health Professionals (VADHP), Registered Nurse (RN) License (Compact or Virginia), DSNP, Dual Eligible Special Needs Plan, Medicare, Medicaid, State Medicaid Agency Contract, SMAC, Long-Term Services and Supports, LTSS, NCQA,

  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.

• About the company

  Sentara Healthcare is a not-for-profit healthcare organization serving Virginia and northeastern North Carolina.

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