Status: Full-Time permanent position (40 hours)
Standard working hours: 8:00 am to 5 pm EST, M-F
Location: This position is remote in Virginia
Job Responsibilities:
Assumes responsibility, accountability and leadership for the daily operations including coordination of work, quality, and service.
First-line supervisor in the Department of Medical Care Management for assigned site/function.
Facilitates the work of assigned team members.
Provides a leadership role in ongoing case manager competency assessment, needs identification and educational offerings.
Provides educational services to the Medical Care Management staff.
Participates in the work activities of assigned teams and provides case management services as needed.
Education:
Bachelor's Degree in Nursing/BSN REQUIRED
Certification/Licensure:
Valid RN license (Compact/VA)
Experience:
3 years of Case Management/Utilization Review experience REQUIRED
Supervisory- Previous Experience preferred
Medicaid and Medicare experience preferred
Experience in Long Term Support Services (LTSS) preferred
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-83633
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Talroo – Health Plan
Keywords: MCO, Managed Care, Health Plan, Healthcare, Medicaid, Medicare, Virginia, Remote, Supervisor, Utilization Management
We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits. The base pay rate for Full Time employment is:$87,443.20-$145,745.60. Additional compensation may be available for this role such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.