INTEGRATED CARE MANAGER

Location
Virginia Beach, VA
Salary
Competitive
Posted
Jan 28, 2019
Closes
Mar 01, 2019
Ref
120194BR
Function
Nurse
Industry
Healthcare
Hours
Full Time
Overview:

Optima Health, Virginia Beach, has an opening for an Integrated Care Manager for the Hospital Review Team. This is a full time, day shift position.

The selected RN for this position will manage the UM responsibilities for multiple PAR facilities and also follows Optima members admitted to out of network facilities. The UM team is responsible for contract negotiations related to single case agreements, care coordination, utilization management, and discharge planning. Members of this team are responsible for adhering to all regulatory bodies including CMS, NCQA, and the BOI.

Three (3) years of RN experience, preferably in case management required.

Optima Health is a service of Sentara Healthcare, so joining Optima is joining the Sentara Healthcare family. Optima Health offers a full suite of commercial health insurance products including employee-owned and employer-sponsored plans, as well as Individual and Family health plans, employee assistance plans and plans serving Medicare and Medicaid enrollees. We offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services.

As a nationally recognized provider of health plan coverage and innovative wellness programs, we live our mission "to improve health everyday." This same commitment and dedication directs our philosophy as an employer. When you join Optima Health, you will experience our deep passion for heal and service excellence while benefiting from a culture of opportunity, learning, career growth, and support --every day.

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!




Other
BLS (if in a clinical setting).All Registered Nurses who do not have their BSN will be required to sign a BSN Agreement committing to successfully obtain their BSN within 5 years of hire. BSN or MSN preferred.

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 strongly preferred.

For those in Behavioral Health - Certification in de-escalation training within 15 days of hire and annually.PACE specific incumbents for this position require a minimum of one year of experience working with the frail or elderly population.

Responsibilities:

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.

Qualifications:

Education Level
RN-Associate's Degree OR
RN-Bachelor's Level Degree OR
RN-Diploma (Non-degree) OR
RN-Master's Level Degree

Experience
Required: Nursing - 3 years

Preferred: None, unless noted in the "Other" section below

License
Required: Registered Nurse

Preferred: Basic Life Support

Skills
Required: Communication, Critical Thinking, Service Orientation

Preferred: None, unless noted in the "Other" section below

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