Integrated Case Manager - Registered Nurse (RN) for ...

Sentara Health Plans is hiring a Integrated Case Manager - Registered Nurse in Culpepper, Page County and the surrounding areas Status: Full-time, permanent position (40 hours)Standard working hours: 8am to 5pm EST, M-FThe position requires both in person/face-to-face assessments and remote telephonic assessments for the LTSS Waiver population in Culpepper, Page County, and the surrounding areas Location: Candidate must reside in Culpepper, Page County, and the surrounding areas Primary 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 issues.Education:BLD - Bachelor's Level Degree preferredCertification/Licensure:Registered Nurse (RN) License (Compact or Virginia) REQUIREDExperience:3 years experience in Nursing REQUIREDCase Management experience preferredHealth Plan, LTSS and Home Health experience preferredSentara 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 servicesu2014all 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 serveTo apply, please go to and use the following as your Keyword Search: JR-91537Talroo u2013 Health Plan Care Coordination, Human Services, Community Health, Health Education, Long Term Care, Health Plan, Social Work, Therapy, Counseling, Psychology, Waiver, LTSS, Medicaid, Managed Care, MCO, Culpepper, Page County, VA, Virginia, Northern VA, NOVA

Created: 2026-03-26