case manager nurse

Your Health

<div>
 Back to Job Openings
 
 
 Nurse Case Manager - Registered Nurse
 
 
 Greenville SC, Lyman SC, Greer SC
 
 
 Apply
 
 
 Share
 
 
 
 We are seeking Registered Nurse to service our patients throughout the Greenville area.
 
 The role of the Nurse Case Manager position is a critical part of the patient&rsquo;s care team. The nurse will visit patients and facilitate with appropriate provider. The Nurse Case Manager will be required to travel to patients&rsquo; homes, long-term care facilities, etc. to evaluate patients and initiate telemedicine visits. Provide quality healthcare in adherence to all applicable laws, regulations, and policies within the scope of practice.
 
 
 
 Nurse Case Manager's perform visits in homes and facilities (ALF and ILF's) in their designated service area
 
 .
 
 You must have reliable transportation as travel is required daily.
 
 This is a full time, salary-based working 8-hr shifts Monday-Friday (8am-5pm)
 
 
 
 The Following Service Area(s) Are Currently Available
 
 
 
 <ul>
 <li>
 Greenville area
 
 
 </li>
 </ul>
 
 About
 
 
 
 We are a leading physician group serving South Carolina and Georgia, dedicated to delivering quality healthcare directly to patients in care facilities, homes, clinics, and virtual visits. Our services include comprehensive primary care, specialty services, and pharmacy support, tailored to meet diverse patient needs. Committed to excellence and innovation, our team collaborates closely with facilities and families to ensure accessible, coordinated, and compassionate care.
 
 
 
 Why Choose a Career at Your Health?
 
 
 
 Providing high quality care for our patients is the center of what we do, and we provide the same care for our employees. Here are some of the benefits that are available to our employees.
 
 
 <ul>
 <li>
 Competitive Compensation Package with Bonus Opportunities
 </li>
 <li>
 Employer Matched 401K
 </li>
 <li>
 Free Visit &amp; Prescriptive Services with HDHP Insurance Plan
 </li>
 <li>
 Employer Matched HSA
 </li>
 <li>
 Generous PTO Package
 </li>
 <li>
 Career Development &amp; Growth Opportunities
 </li>
 <li>
 Vehicle allowance
 
 
 </li>
 </ul>
 
 What Are We Looking For?
 
 
 
 Your Health is currently looking for a Registered Nurse to join our growing primary care family. A successful Nurse Case Manager will be able to perform these essential duties and responsibilities. Reasonable accommodations may be made, in accordance with applicable law, to enable individuals with disabilities to perform the essential functions.
 
 
 The following is a list of essential functions, which may be subject to change at any time and without
 
 
 notice. Management may assign new duties, reassign existing duties, and/or eliminate function(s).
 
 
 
 Area Of Responsibility
 
 
 
 <ul>
 <li>
 Facilitate receiving all medical records from the patient&rsquo;s primary provider and specialists.
 </li>
 <li>
 Review medical records.
 </li>
 <li>
 Complete consents with patients.
 </li>
 <li>
 Enroll patients in Care Management, if they meet eligibility criteria.
 </li>
 <li>
 Initiate a Care Management Plan of Care, if the patient is eligible.
 </li>
 <li>
 Capture all diagnoses at the highest specificity by creating gaps and ensure they are accepted.
 </li>
 <li>
 Complete AWV&rsquo;s to be reviewed by the provider.
 </li>
 <li>
 Complete cognitive impairment screenings.
 </li>
 <li>
 Complete Social Determinants of Health (SDoH) assessments and/or screenings.
 </li>
 <li>
 Complete ACP&rsquo;s to be reviewed with the patient by the provider.
 </li>
 <li>
 Evaluate for home health, hospice, palliative, or consults with Your Health Specialty Division, etc.
 </li>
 <li>
 Evaluate for RPM devices, resources, or tools that may improve the patient&rsquo;s quality of life.
 </li>
 <li>
 Communicate and coordinate care.
 </li>
 <li>
 Reconcile prescribed and OTC medications, vitamins, supplements, herbal remedies, and other treatments.
 </li>
 <li>
 Provide post-discharge education.
 </li>
 <li>
 Evaluate for adaptive equipment and DME.
 </li>
 <li>
 Evaluate for safe environment.
 </li>
 <li>
 Evaluation of acute condition(s) or follow-up from previous visit.
 </li>
 <li>
 Appropriately and accurately document and log Care Management activities. Work in conjunction with care team to keep the patients Care Management care plans up to date.
 
 
 </li>
 </ul>
 
 Qualifications
 
 
 
 <ul>
 <li>
 Must be a licensed nurse. Registered nurse preferred. License must be in good standing with appropriate board/issuer.
 </li>
 <li>
 A minimum of three (3) years clinical experience preferred.
 </li>
 <li>
 Experience in community settings preferred.
 </li>
 <li>
 Proven ability to effectively communicate and collaborate with interdisciplinary care teams, patients, and caregivers.
 </li>
 <li>
 Strong written and verbal skills.
 </li>
 <li>
 Basic computer knowledge.
 </li>
 <li>
 Ability to manage and demonstrate effective leadership skills.
 </li>
 <li>
 Should demonstrate good interpersonal and communication skills under all conditions and circumstances.
 </li>
 <li>
 Ability to foster a cooperative work environment.
 </li>
 <li>
 Team player with ability to manage multiple responsibilities and demonstrate sound judgment.
 </li>
 <li>
 Must be able to work flexible hours and travel between offices, facilities, etc. Must be a licensed driver with an automobile that is insured in accordance with state and/or organizational requirements and is in good working order
 
 
 </li>
 </ul>
 Apply
</div>

Nurse Case Manager - Registered Nurse

CVS Health

<div>We&rsquo;re building a world of health around every individual &mdash; shaping a more connected, convenient and compassionate health experience. At CVS Health&reg;, you&rsquo;ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger &ndash; helping to simplify health care one person, one family and one community at a time.
Position Summary
Help us elevate our patient care to a whole new level! Join our Community Care team as an industry leader in serving our members by utilizing best-in-class operating and clinical models. You can have life-changing impact on our Community Care members. Community Care is a member centric, team-delivered, community-based care management model that joins members where they are. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members&rsquo; health care and social determinant needs. Join us in this exciting opportunity as we grow and expand to change lives in new markets across the country.
Community Care Case Manager use a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual&rsquo;s and family&rsquo;s comprehensive health needs through communication and available resources to promote quality, cost effective outcomes.
Additional responsibilities to include but not limited to the following:<ul><li>
Acts as a liaison with member/client /family, employer, provider(s), insurance companies, and healthcare personnel as appropriate.</li><li>
Implements and coordinates all case management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care that can include consultant referrals, home care visits, the use of community resources, and alternative levels of care.</li><li>
Interacts with members/clients telephonically or in person. May be required to meet with members/clients in their homes, worksites, or physician&rsquo;s office to provide ongoing case management services.</li><li>
Assesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status; develops a plan of care to facilitate the member/client&rsquo;s appropriate condition management to optimize wellness and medical outcomes, aid timely return to work or optimal functioning, and determination of eligibility for benefits as appropriate.</li><li>
Communicates with member/client and other stakeholders as appropriate (e.g., medical providers, attorneys, employers and insurance carriers) telephonically or in person.</li><li>
Prepares all required documentation of case work activities as appropriate.</li><li>
Interacts and consults with internal multidisciplinary team as indicated to help member/client maximize best health outcomes.</li><li>
May make outreach to treating physician or specialists concerning course of care and treatment as appropriate.</li><li>
Provides educational and prevention information for best medical outcomes.</li><li>
Applies all laws and regulations that apply to the provision of rehabilitation services; applies all special instructions required by individual insurance carriers and referral sources.</li><li>
Conducts an evaluation of members/clients&rsquo; needs and benefit plan eligibility and facilitates integrative functions using clinical tools and information/data.</li><li>
Utilizes case management processes in compliance with regulatory and company policies and procedures.</li><li>
Facilitates appropriate condition management, optimize overall wellness and medical outcomes, appropriate and timely return to baseline, and optimal function or return to work.</li><li>
Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes, as well as opportunities to enhance a member&rsquo;s/client&rsquo;s overall wellness through integration.</li><li>
Monitors member/client progress toward desired outcomes through assessment and evaluation.</li></ul>
Required Qualifications<ul><li>
Candidate must have active and unrestricted Compact Registered Nurse (RN) Licensure in Alabama, Arkansas, Maryland, Mississippi, North Carolina, South Carolina, Tennessee, Virginia, Georgia, or Florida</li><li>
3+ years of clinical practical experience preference: (diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac, Home Health) with Medicare members</li><li>
2+ years of case management, discharge planning and/or home health care coordination experience</li><li>
Proficiency with standard corporate software applications, including Microsoft Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications</li><li>
Able to work in a fast paced high volume environment and utilize time management and prioritization skills.</li><li>
Efficient and effective computer skills including navigating multiple systems and keyboarding</li></ul>
Preferred Qualifications<ul><li>
Bilingual - Spanish</li><li>
Excellent analytical and problem-solving skills</li><li>
Effective communications, organizational, and interpersonal skills</li><li>
Certified Case Manager</li><li>
National professional certification (CRC, CDMS, CRRN, COHN, or CCM)</li></ul>
Education
<ul><li>Associate's Degree in Nursing or Nursing Diploma (REQUIRED)</li><li>
Bachelor's Degree in Nursing (PREFERRED)</li></ul>
License<ul><li>
Active and unrestricted Compact Registered Nurse (RN) Licensure</li></ul>
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is:
$60,522.00 - $129,615.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in our comprehensive and competitive mix of pay and benefits &ndash; investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul><li>
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li><li>
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li><li>
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li></ul>
For more information, visit https://jobs.cvshealth.com/us/en/benefits
We anticipate the application window for this opening will close on: 03/24/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.</div>

Case Manager, Registered Nurse - Remote

<div>We&rsquo;re building a world of health around every individual &mdash; shaping a more connected, convenient and compassionate health experience. At CVS Health&reg;, you&rsquo;ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger &ndash; helping to simplify health care one person, one family and one community at a time.<div>
Position Summary
This Case Manager RN role is with the Costco Team and is fully remote; however, it is preferred that candidates reside within 45 minutes (reasonable driving distance) from the local office located at 7034 Alamo Downs Pkwy, San Antonio, TX 78238. 
Scheduled - Monday through Friday 8:00am-5:00pm CST with flexibility to rotate to 10:00am-7:00pm CST on occasion when required to meet business needs.<h2 class="jobSectionHeader"> 
No weekends or holidays will be required. 
 
The Case Manager RN is responsible for telephonically and/or face to face assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member&rsquo;s overall wellness. 
 
The Case Manager RN develops a proactive course of action to address issues presented to enhance the short- and long-term outcomes as well as opportunities to enhance a member&rsquo;s overall wellness through integration. 
 
The Case Manager RN job duties include (not an all-encompassing list):</h2><ul><li><h2 class="jobSectionHeader">
Through the use of clinical tools and information/data review, conducts an evaluation of member&rsquo;s needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans.</h2></li><li><h2 class="jobSectionHeader">
Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues.</h2></li><li><h2 class="jobSectionHeader">
Assessments consider information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality.</h2></li><li><h2 class="jobSectionHeader">
Reviews prior claims to address potential impact on current case management and eligibility.</h2></li><li><h2 class="jobSectionHeader">
Assessments include the member&rsquo;s level of work capacity and related restrictions/limitations.</h2></li><li><h2 class="jobSectionHeader">
Using a holistic approach assess the need for a referral to clinical resources for assistance in determining functionality.</h2></li><li><h2 class="jobSectionHeader">
Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management.</h2></li><li><h2 class="jobSectionHeader">
Utilizes case management processes in compliance with regulatory and company policies and procedures.</h2></li><li><h2 class="jobSectionHeader">
Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.</h2></li></ul>
Required Qualifications<ul><li><h2 class="jobSectionHeader">
Must have active current and unrestricted RN multistate licensure in the state where they reside.</h2></li><li><h2 class="jobSectionHeader">
Willingness to obtain additional state licenses will be required upon hire (expenses will be covered by company).</h2></li><li><h2 class="jobSectionHeader">
3+ years clinical practice experience as an RN required</h2></li><li><h2 class="jobSectionHeader">
1+ year(s) experience utilizing multiple computer systems and applications including Microsoft Word, Excel, Outlook, and web-based applications
</h2></li><li><h2 class="jobSectionHeader">Must be able to work Monday through Friday 8:00am-5:00pm CST with flexibility to rotate to 10:00am-7:00pm CST on occasion when required to meet business needs.</h2></li></ul>
Preferred Qualifications<ul><li><h2 class="jobSectionHeader">
Case Management in an integrated model</h2></li><li><h2 class="jobSectionHeader">
Bilingual in Spanish and English</h2></li><li><h2 class="jobSectionHeader">
Strong computer skills</h2></li><li><h2 class="jobSectionHeader">
Residing within 45 minutes (reasonable driving distance) from the local office located at 7034 Alamo Downs Pkwy, San Antonio, TX 78238.</h2></li><li><h2 class="jobSectionHeader">
Travel to the San Antonio office may be required for quarterly meetings or PRN meetings.</h2></li></ul> 
Education<ul><li><h2 class="jobSectionHeader">
Associates Degree in Nursing required</h2></li><li><h2 class="jobSectionHeader">
BSN preferred</h2></li></ul></div>
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is:
$60,522.00 - $129,615.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in our comprehensive and competitive mix of pay and benefits &ndash; investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul><li>
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li><li>
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li><li>
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li></ul>
For more information, visit https://jobs.cvshealth.com/us/en/benefits
We anticipate the application window for this opening will close on: 04/04/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.</div>

Case Manager Registered Nurse- San Antonio, TX

<div>We&rsquo;re building a world of health around every individual &mdash; shaping a more connected, convenient and compassionate health experience. At CVS Health&reg;, you&rsquo;ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger &ndash; helping to simplify health care one person, one family and one community at a time.
Job Summary:
*Must possess RN NY license**
The Care Manager&mdash;Registered Nurse is a key member of our Special Needs Plan (SNP) care team, responsible for coordinating care for members who often face multiple chronic medical and behavioral health conditions, as well as various social determinants of health (SDoH) needs. This role involves conducting comprehensive assessments to evaluate members&rsquo; needs and addressing SDoH challenges by connecting them with appropriate resources and support services. The Social Worker provides education and guidance to members and their families on managing chronic conditions and navigating the healthcare system. Additionally, the Care Manager develops and implements individualized care plans, monitors member progress, advocates for necessary services, and collaborates with the interdisciplinary care team to ensure optimal health outcomes. Accurate and timely documentation of assessments and interventions is essential, as is participation in team meetings to discuss member status and care strategies.
Key Responsibilities:<ul><li>
50-75% of the day is dedicated to telephonic engagement with members and the coordination of their care.</li><li>
Compiles all available clinical information and partners with the member to develop an individualized care plan that encompasses goals and interventions to meet the member&rsquo;s identified needs.</li><li>
Provides evidence-based disease management education and support to help the member achieve health goals.</li><li>
Ensure the appropriate members of the interdisciplinary care team are involved in the member&rsquo;s care.</li><li>
Provides care coordination to support a seamless health care experience for the member.</li><li>
Meticulous documentation of care management activity in the member&rsquo;s electronic health record.</li><li>
Collaborate with other participants of the Interdisciplinary Care Team to address barriers to care and develop strategies for maintaining the member&rsquo;s stable health condition.</li><li>
Identifies and connects members with health plan benefits and community resources.</li><li>
Meets regulatory requirements within specified timelines.</li><li>
The Care Manager RN supports other members of the Care Team through clinical decision making and guidance as needed.</li><li>
Additional responsibilities as assigned by leadership to support team objectives, enhance operational efficiency, and ensure the delivery of high-quality care to members. This may include participating in special projects, contributing to process improvement initiatives, or assisting with mentoring new team members.</li></ul>
Essential Competencies and Functions:<ul><li>
Ability to meet performance and productivity metrics, including call volume, successful member engagement, and state/federal regulatory requirements of this role.</li><li>
Conduct oneself with integrity, professionalism, and self-direction.</li><li>
Experience or a willingness to thoroughly learn the role of care management within Medicare and Medicaid managed care.</li><li>
Familiarity with community resources and services.</li><li>
Ability to navigate and utilize various healthcare technology tools to enhance member care, streamline workflows, and maintain accurate records.</li><li>
Maintain strong collaborative and professional relationships with members and colleagues.</li><li>
Communicate effectively, both verbally and in writing.</li><li>
Excellent customer service and engagement skills.</li></ul>
Required Qualifications<ul><li>
Must have active and unrestricted Registered Nurse (RN) licensure in the state of NY</li><li>
Proficient in Microsoft Office Suite, including Word, Excel, Outlook, OneNote, and Teams, with the ability to effectively utilize these tools within the context of the CM RN role.</li><li>
Access to a private, dedicated space to conduct work effectively to meet The requirements of the position.</li><li>
Confidence working at home / independent thinker, using tools to collaborate and connect with teams virtually.</li><li>
Minimum 3+ years of nursing experience</li><li>
Minimum 2+ years of case management, discharge planning and/or home healthcare coordination experience</li></ul>
Preferred Qualifications<ul><li>
Experience providing care management for Medicare and/or Medicaid members.</li><li>
Experience working with individuals with SDoH needs, chronic medical conditions, and/or behavioral health.</li><li>
Experience conducting health-related assessments and facilitating the care planning process.</li><li>
Bilingual skills, especially English-Spanish</li></ul>
Education<ul><li>
Associate&rsquo;s of Science in Nursing (ASN) degree and relevant experience in a health care-related field (REQUIRED)</li><li>
Bachelor&rsquo;s of Science in Nursing (BSN) (PREFERRED)</li></ul>
License<ul><li>
Must have active and unrestricted Registered Nurse (RN) licensure in the state of NY</li></ul>
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is:
$66,575.00 - $142,576.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in our comprehensive and competitive mix of pay and benefits &ndash; investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul><li>
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li><li>
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li><li>
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li></ul>
For more information, visit https://jobs.cvshealth.com/us/en/benefits
We anticipate the application window for this opening will close on: 04/10/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.</div>

Case Manager Registered Nurse (Work from Home - New York License)

Sentara

<div>Department and Name: Care Management &ndash; SHP VA- Health Plan 
Physical Location: Virginia Beach, VA 
Location Type: Remote 
Employment Status: Regular-Full time 
Shift: First (Days) 
Posted Date: March 19, 2026</div>
 <div><div><div><h2 class="jobSectionHeader">Job Overview</h2></div><div><div><div>
<div><h1 class="jobSectionHeader">Sentara Health Plans is hiring an Integrated Nurse Case Manager/RN/Maternity/OBGYN for Virginia Beach, Norfolk, Chesapeake, Suffolk and Portsmouth, VA and the surrounding areas!</h1>
The position requires both in-person face-to-face assessments and remote telephonic assessments for the low and high risk pregnant population/Maternity/OB/L&amp;D/Mother Baby/Postpartum in Virginia Beach, Norfolk, Chesapeake, Suffolk and Portsmouth, VA and the surrounding areas.
Status: Full-time, permanent position (40 hours) 
Standard working hours: 8am to 5pm EST, M-F 
Location: Applicants must be reside in Virginia Beach, Norfolk, Chesapeake, Suffolk and Portsmouth, VA and the surrounding areas.
Primary responsibilities include:
<ul><li>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 continuum
</li><li>Performs 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 services
</li><li>Identifies members for high-risk complications and coordinates care in conjunction with the member and health care team
</li><li>Manages chronic illnesses, co-morbidities, and/or disabilities ensuring cost effective and efficient utilization of health benefits; conducts gap in care management for quality programs
</li><li>Assists with the implementation of member care plans by facilitating authorizations/referrals within benefits structure or extra-contractual arrangements, as permissible
</li><li>Interfaces with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on care management treatment plans
</li><li>Presents cases at case conferences for multidisciplinary focus. Ensures compliance with regulatory, accrediting and company policies and procedures
</li><li>May assist in problem solving with provider, claims or service issues.
</li></ul>Education:
<ul><li>Bachelors Degree in Nursing preferred
</li></ul>Certification/Licensure:
<ul><li>Registered Nurse (RN) License (Compact or Virginia) REQUIRED
</li></ul>Experience:
<ul><li>3 years experience in Nursing REQUIRED
</li><li>Case Management experience preferred
</li><li>Managed Care or Health Plan experience preferred
</li><li>Experience working with low and high risk pregnant population/Maternity/OB/L&amp;D/Mother Baby/Postpartum experience preferred
</li><li>Strong knowledge of physical, psychological, socio-cultural, and cognitive patient needs.
</li><li>Excellent communication skills, both oral and written, as well as strong problem-solving and analytical
</li></ul>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 &amp; 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&mdash;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-96069
#Indeed
Talroo &ndash; Nursing
Care Coordination, Case Management, RN, Case Manager, Registered Nurse, BSN, ADN, Nursing, Managed Care, MCO, Health Plan, high-risk pregnant members, Maternity, OBGYN, Labor and Delivery, Mother and Baby, Postpartum, L&amp;D, Virginia Beach, Norfolk, Chesapeake, Suffolk, Portsmouth, VA
</div></div></div></div></div><div><div><h2 class="jobSectionHeader">About Us</h2></div><div><div>
Sentara Health, an integrated, not-for-profit health care delivery system, celebrates more than 135 years in pursuit of its mission &ndash; &ldquo;we improve health every day.&rdquo; Sentara is one of the largest health systems in the U.S. Mid-Atlantic and Southeast, and among the top 20 largest not-for-profit integrated health systems in the country, with 34,000 employees, 12 hospitals in Virginia and Northeastern North Carolina including 10 hospitals with the prestigious Magnet&reg; recognition, and the Sentara Health Plans division which serves more than 1 million members in Virginia and Florida. Sentara is recognized nationally for clinical quality and safety, and is strategically focused on innovation and creating an extraordinary health care experience for our patients and members. Sentara was named a Health Quality Innovator of the Year (2024), was recognized by Forbes as &ldquo;America&rsquo;s Best-In-State Employer&rdquo; (2024), &ldquo;Best Employer for Veterans&rdquo; (2022, 2023), and &ldquo;Best Employer for Women&rdquo; (2020), and named to IBM Watson Health&rsquo;s &ldquo;Top 15 Health Systems&rdquo; (2021, 2018).
Learn more (Opens in a new tab)</div></div></div></div>

Integrated Nurse Case Manager/Registered Nurse (RN) for Maternity/OBGYN for Virginia Beach, Norfolk, Chesapeake, Suffolk and Portsmouth, VA

AccentCare

<div><div>RN / Registered Nurse, Home Health</div><div>
Location: Ormond Beach</div><div>
Position: RN Case Manager, Home Health</div><div>
Position Type: Full-Time</div><div>
Remote/Virtual Position: No</div><div>
Coverage Area: Ormond Beach to Daytona</div><div></div><div> 
Find Your Passion and Purpose as an Registered Nurse, Home Health Case Manager</div><div>
Salary: $75,000-$92,000 
Schedule: Mon-Fri</div><div></div><div> 
Offer Based on Years of Experience</div><div> 
Reimagining Your Career in Home Health</div><div>
Caring for others is more than what you do &mdash; it&rsquo;s who you are. At AccentCare, you&rsquo;ll join a purpose-driven, collaborative culture that sets the standard for excellence and gives you the trust and tools to do your best work. You&rsquo;ll belong to a team that cares deeply for patients and each other; a team committed to consistently providing exceptional care.</div><div>
We&rsquo;re proud to be named one of America&rsquo;s Greatest Workplaces 2025 by Newsweek &mdash; a reflection of our shared commitment to excellence, integrity and compassion as we shape the future of aging in place. When you thrive, so does the community of care we&rsquo;re building together.</div><div></div> 
Be the Best RN Case Manager You Can Be
If you meet these qualifications, we want to meet you!<ul><li>
Graduate from an approved school of professional nursing and currently licensed to practice as a registered nurse in the state of agency operation.</li><li>
One (1) year experience as a RN.</li></ul>
Required Certifications and Licensures:<ul><li>
Licensed to practice as a registered nurse in the state of agency operation.</li><li>
Must possess and maintain valid CPR certification while employed in a clinical role.</li><li>
Must be a licensed driver with an automobile that is insured in accordance with state and/or organization requirements and is in good working order. Ability to travel to all business locations.</li></ul>
Our Investment in You<div>
Caring for others starts with caring for you. We&rsquo;re committed to fostering a purpose-driven workplace where you feel supported, and that means prioritizing your physical, financial and mental well-being. Our benefits include:</div> 
<div></div><ul><li>
Medical, dental, and vision coverage</li><li>
Paid time off and paid holidays</li><li>
Professional development opportunities</li><li>
Company-matching 401(k)</li><li>
Flexible spending and health savings accounts</li><li>
Wellness offerings such as an employee assistance program, pet insurance, and access to Calm, a meditation, sleep, and relaxation app</li><li>
Programs to celebrate achievements, milestones, and fellow employees</li><li>
Company store credit for your first AccentCare-branded scrubs for patient-facing employees</li><li>
And more!</li></ul><div> 
Come As You Are</div><ul><li>
At AccentCare, you&rsquo;re part of a community that cares &mdash; for patients and each other. You can rest assured we offer equal employment opportunities regardless of race, ethnicity, sex, sexual orientation, gender identity, religion, national origin, age or disability.</li></ul></div>

Registered Nurse, Home Health

RN / Registered Nurse, Home Health Location: Watkinsville Position: RN Case Manager, Home Health Position Type: Full-Time Remote/Virtual Position: No Coverage Area: Watkinsville and Surrounding areas Find Your Passion and Purpose as an Registered Nurse, Home Health Case Manager Salary: $85,000-$95,000 Schedule: Mon-Fri Offer Based on Years of Experience Reimagining Your Career in Home Health Caring for others is more than what you do &mdash; it&rsquo;s who you are. At AccentCare, you&rsquo;ll join a purpose-driven, collaborative culture that sets the standard for excellence and gives you the trust and tools to do your best work. You&rsquo;ll belong to a team that cares deeply for patients and each other; a team committed to consistently providing exceptional care. We&rsquo;re proud to be named one of America&rsquo;s Greatest Workplaces 2025 by Newsweek &mdash; a reflection of our shared commitment to excellence, integrity and compassion as we shape the future of aging in place. When you thrive, so does the community of care we&rsquo;re building together. Be the Best RN Case Manager You Can Be If you meet these qualifications, we want to meet you! Graduate from an approved school of professional nursing and currently licensed to practice as a registered nurse in the state of agency operation. One (1) year experience as a RN. Required Certifications and Licensures: Licensed to practice as a registered nurse in the state of agency operation. Must possess and maintain valid CPR certification while employed in a clinical role. Must be a licensed driver with an automobile that is insured in accordance with state and/or organization requirements and is in good working order. Ability to travel to all business locations. Our Investment in You Caring for others starts with caring for you. We&rsquo;re committed to fostering a purpose-driven workplace where you feel supported, and that means prioritizing your physical, financial and mental well-being. Our benefits include: Medical, dental, and vision coverage Paid time off and paid holidays Professional development opportunities Company-matching 401(k) Flexible spending and health savings accounts Wellness offerings such as an employee assistance program, pet insurance, and access to Calm, a meditation, sleep, and relaxation app Programs to celebrate achievements, milestones, and fellow employees Company store credit for your first AccentCare-branded scrubs for patient-facing employees And more! Come As You Are At AccentCare, you&rsquo;re part of a community that cares &mdash; for patients and each other. You can rest assured we offer equal employment opportunities regardless of race, ethnicity, sex, sexual orientation, gender identity, religion, national origin, age or disability.

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