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 Pla