Care Coordinator

City/State

Overview

Work Shift

Sentara Health Plans Community Care is actively recruiting for a Care Coordinator.

This is a remote position however traveling to Nursing Facilities and Members Home is required in Tide Water, Norfolk and Virginia Beach or Richmond and its surroundings.

Key Responsibilities:

• Develop and implement individualized care plans for members to address their physical, behavioral, social, and long-term care needs.
• Perform face-to-face clinical assessments to identify, evaluate, and manage members' needs.
• Coordinate care for high-risk members, including those with chronic conditions, co-morbidities, or disabilities.
• Manage care to ensure cost-effective and efficient utilization of health benefits, including conducting gap-in-care management for quality programs.
• Facilitate authorizations, referrals, and care plan implementation within benefits and coverage structures.
• Work closely with Medical Directors, Physician Advisors, and Interdisciplinary Teams to present and discuss case management treatment plans.
• Ensure compliance with regulatory, accrediting, and company policies and procedures.
• Assist with problem-solving related to provider, claims, or service issues as needed.

Requirements:

• Must possess a bachelor's degree in health & human services or one of the following related Fields:
  
  -Art Therapy
  -Behavioral Sciences
  -Child Development
  -Cognitive Sciences
  -Community Mental Health Counseling (MH, Vocational, Pastoral, etc.)
  -Counselor Education
  -Early Childhood Development
  -Educational Psychology
  -Gerontology
  -Healthcare Administration
  -Human Development
  -Human Services
  -Marriage and Family Therapy
  -Music Therapy
  -Nursing
  -Pharmacy
  -Psychiatric Rehabilitation
  -Psychology
  -Rehabilitation Counseling
  -Social Work
  -Sociology
  -Special Education
  -Speech Therapy
  -Therapeutic Recreation
  -Vocational Rehabilitation
  All degrees must be from schools that are listed as accredited on the U.S. Department of Education College Accreditation database found on the U.S. Department of Education website. Schools that are not listed on the database do not meet the standard as accredited. Degrees that have been obtained from schools outside the United States will be reviewed individually.
• 1 year of long-term care required.
• Health plan and Medicaid experience preferred.
• Strong knowledge of physical, psychological, socio-cultural, and cognitive patient needs.
• Excellent communication skills, both oral and written, as well as strong problem-solving and analytical skills.
• Ability to work independently and collaboratively in a remote, fast-paced environment.

Benefits: Sentara offers an attractive array of full-time benefits to include Medical, Dental, Vision, Paid Time Off, Sick, Tuition Reimbursement, a 401k/403B, 401a, Performance Plus Bonus, Career Advancement Opportunities, Work Perks and more.

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, https://www.sentaracareers.com/explore-sentara/benefits/

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

Keywords: Talroo Health Plans, health plan, health care, case management, long term care, Medicaid, #ZipRecruiter

Job Summary

Qualifications:

Skills

Sentara Healthcare prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.

Per Clinical Laboratory Improvement Amendments (CLIA), some clinical environments require proof of education; these regulations are posted at ecfr.gov for further information. In an effort to expedite this verification requirement, we encourage you to upload your diploma or transcript at time of application.

In support of our mission "to improve health every day," this is a tobacco-free environment.