Job Description

Sentara Health Plans Community Care is hiring a Care Coordinator. This is a remote position however traveling to Nursing Facilities and Members Home is required in Richmond, VA and its surroundings. The Care Coordinator performs a variety of casework duties and provides case management services to patients, families, and designated caregivers. Must develop, participate and monitor multidisciplinary collaboration of services to patients where appropriate. Assist adult patients and their families with personal and environmental difficulties associated with medical condition up to and including at time of terminal illnesses. 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. Education: Must possess a 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. Experience: 1 year of long-term care required, HealthPlan and Medicaid 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: 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, Short-Term Disability, and Critical Illness plans; Life Insurance; 401k/403B with Employer Match; Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education; Student Debt Pay Down – $10,000; Reimbursement for certifications and free access to complete CEUs and professional development; Pet Insurance; Legal Resources Plan; Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met. Sentara Health is an equal opportunity employer and 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. In support of our mission “to improve health every day,” this is a tobacco-free environment. For positions that are available as remote work, Sentara Health employs associates in multiple states including Virginia.

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