Patient Care Specialist - Behavioral Health

Sentara Health Plans is currently hiring an Integrated Nurse Case Manager in Tidewater VirginiaStatus: Full Time (40 hrs/wk)Shift: Day (8am-5pm)Location: Remote in Tidewater, VA (Requires Travel)Position is remote but does require in person face-to-face assessments multiple times throughout the week. Candidates must be able to travel frequently throughout the week to complete in person assessments.Location of assessments include: Virginia Beach, Chesapeake, Norfolk, Suffolk, Portsmouth. May occasionally include Hampton, Newport News, WilliamsburgPrimary responsibilities include:Responsible for case management services within 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 continuumPerforms telephonic or face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical and behavioral health, social services and long-term servicesIdentifies members for high-risk complications and coordinates care in conjunction with the member and health care teamManages chronic illnesses, co-morbidities, and/or disabilities ensuring cost effective and efficient utilization of health benefits; conducts gap in care management for quality programsAssists with the implementation of member care plans by facilitating authorizations/referrals within benefits structure or extra-contractual arrangements, as permissibleInterfaces with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on care management treatment plansPresents cases at case conferences for multidisciplinary focus. Ensures compliance with regulatory, accrediting and company policies and proceduresMay assist in problem solving with provider, claims or service issuesPreferred: Private duty nursing experience and knowledgeable with ventilators in a facility or homeEducationAssociates or Bachelors Degree in Nursing (Required)Certification/LicensureVirginia or Compact RN License (Required)Experience3 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) Care Coordination, Case Management, Human Services, Community Health, Health Education, RN Case Manager, Registered Nurse, BSN, ADN, Private Duty, Ventilator, LinkedIn, Talroo-NursingSentara Rockingham Memorial -Behavioral Health is hiring a Full-Time Patient Care SpecialistAs a Patient Care Specialist with Sentara Healthcare, you will provide non-clinical support within a physician's office and ensure an excellent patient experience by performing a variety of complex administrative tasks to support patient care delivery. Primary duties include answering phones, scheduling appointments, and answering patient questions. In this role, you will find that teamwork is exceptional, with everyone working together to ensure the best care for our patients. Click to hear Joyce tell us about a day in the life of a Patient Care Specialist with Sentara Healthcare.EducationHS DiplomaAssociate Level degree or higher in lieu of the required experience will be considered.Experience3 years Customer Service experience required.1 year experience with Health Insurance Plans, Medical Records Data, Medical Terminology, Registration, Scheduling, or Third-Party Payers required.Electronic Medical Record preferred. Patient Care Representative, Customer Service, Talroo-Allied Health, Medical Office

Created: 2025-11-20