Integrated Nurse Case Manager

Integrated Nurse Case Manager

Sentara Health

Location: Lexington, VA

Type: Full-time, permanent (40 hours)

Hours: 8 AM to 5 PM EST, Monday through Friday

Integrated Nurse Case Manager responsible for case management services within the scope of licensure, developing, monitoring, evaluating, and revising member care plans to optimize healthcare across the continuum. Provides telephonic or face‑to‑face clinical assessments for physical, behavioral, social health, and long‑term services. Coordinates care for high‑risk complications, manages chronic illnesses, and facilitates authorizations/referrals. Interfaces with medical directors, physician advisors, interdisciplinary teams, and presents cases at multidisciplinary conferences.

• Provide case management services within licensure scope, including care plan development and revision.
• Perform telephonic or face‑to‑face assessments for member needs, including physical and behavioral health, social services, and long‑term care.
• Identify members for high‑risk complications and coordinate care with the member and health care team.
• Manage chronic illnesses, comorbidities, and disabilities ensuring cost‑effective utilization of health benefits and address gaps in care.
• Assist with implementation of member care plans by facilitating authorizations/referrals within benefit structures.
• Interface with Medical Directors, Physician Advisors, and interdisciplinary teams for treatment plan management.
• Present cases at case conferences for multidisciplinary focus, ensuring compliance with regulatory, accrediting and company policies.
• Assist in problem‑solving with provider, claims or service issues.

• Associate or Bachelor’s Degree in Nursing (required).

• Registered Nurse (RN) license (Compact or Virginia) required.

• Minimum 3 years of nursing experience (required).
• Case management experience preferred.
• Managed care or health plan experience preferred.
• Experience with low and high‑risk maternity/pregnancy populations (preferred).
• Strong knowledge of physical, psychological, socio‑cultural, and cognitive patient needs.
• Excellent oral and written communication skills, strong problem‑solving and analytical abilities.

• Medical, Dental, Vision plans
• Adoption, Fertility and Surrogacy reimbursement up to $10,000
• Paid time off and sick leave
• Paid parental & family caregiver leave
• Emergency backup care
• Long‑term and short‑term disability, and critical illness plans
• Life insurance
• 401(k)/403(b) with employer match
• Tuition assistance – $5,250 per year and discounted educational opportunities
• Student debt paydown – $10,000
• Reimbursement for certifications and CEUs
• Pet insurance
  
  Legal resources plan
• Opportunities to earn discretionary bonus per eligibility criteria.

Sentara Health is an equal opportunity employer and prides itself on diversity and inclusiveness of its workforce. For positions that are available as remote work, Sentara Health employs associates in 51 states.

To apply, go to  and use keyword JR‑89064.