Registered Nurse (RN) - Pre-Auth Team

Norfolk, VA
Aug 14, 2018
Oct 19, 2018
Full Time
Job Description: Responsible and accountable for the provision and facilitation of comprehensive care coordination services and quality outcomes for patients across the continuum. Promotes effective utilization and monitoring of health services, collaborates and communicates with the healthcare team and patient/caregiver to manage care and transitions. Develops and/or implements a comprehensive care plan based on assessment and evaluation of patient/caregiver needs. Functions in one of the following practice settings: Acute Care, Service Lines, Ambulatory/Community-based, Home Health, and Long Term Care. Education Level
RN-Bachelor's Level Degree

Required: Nursing - 1 year

Required: Basic Life Support, Registered Nurse

Optima Health Community Care is hiring a Registered Nurse (RN)
for the Government Behavioral Health team in Norfolk, VA.


Monday - Friday, 8am-5pm

Department/Position Overview:

In this office-based position the Registered Nurse (RN) will have a keen understanding of medical necessity combined with a knowledge of Behavioral Health. While this position is currently located in Norfolk, VA; it will ultimately be located at the Virginia Beach, VA office in support of our hospital review team. Minimum BSN degree required and at least 3 years of RN experience, preferably in case management. Previous authorizations and CMHRS experience is a plus.

Division Highlights:

Optima Health Community Care is a Commonwealth Coordinated Care Plus (CCC Plus) Medicaid plan for many older people and those with disabilities. CCC Plus is a Medicaid managed care program through the Virginia Department of Medical Assistance Services (DMAS).

With Optima Health Community Care, members benefit from an individualized, fully-integrated program with a state-wide network of providers. As an Optima Health Community employee, you will join a care team committed to providing customized and personalized support and services in the community that our members can count on. Optima Health is a service of Sentara Healthcare, so joining Optima is joining the Sentara Healthcare family.

Sentara Benefits:

Sentara employees strive to make our communities healthier places to live. We're setting the standard for medical excellence within a vibrant, creative, and highly productive workplace. For more information about our employee benefits, CLICK HERE!

Join our team, where we are committed to quality healthcare, improving health every day, and provide the opportunity for training, development, growth!

BLS (if in a clinical setting). 1 year Nursing directly working with individuals who meet the long term and support services population criteria. For Integrated Care Management departments, specialty certification required within one year of eligibility (ACM, CCM, CCCTM or RN-BC). For other service lines, certification based on specialty area required within one year of eligibility. 3 years Case Management experience preferred.

Keyword: authorizations, research, Registered Nurse, RN, managed care, CMHRS

Equal Opportunity Employer

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