Care Coordinator/ Licensed Practical Nurse (LPN)for LTSS Waiver/ Home Health in Culpeper, Fauquier, Madison, Orange, Rappahannock, VA

Sentara Health Plans is hiring a Care Coordinator/ Licensed Practical Nurse (LPN) for LTSS Waiver/ Home Health in Culpeper, Warrenton, Fauquier, Catlett, Madison, Orange, Brightwood, Bealeton, Washington, Rappahannock County, Gordonsville, VA!

Status:

Full-time, permanent position (40 hours) Standard working hours: 8am to 5pm

EST, M-F

Job responsibilities: Responsible for facilitation, implementation and coordination of Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Member Outreach Program and overall compliance with immunization and EPSDT examinations. Serves as health plan resource for EPSDT/Well Child Program and all childhood exams, screenings, and vaccinations recommended by DMAS and per HEDIS measures. Responsible for data entry and monitoring of reports to increase utilization of EPSDT services. Maintains tracking system to identify new enrollees and children's non-compliance with EPSDT periodicity and immunization schedules. Ensures access to periodic preventive health care for members under the age of 21 years by promoting and coordinating child wellness in alignment with DMAS, health plan, and other professional organization initiatives. Conducts notifications of periodic screening requirements; develops educational materials and provides training to members/providers. Triages members with special healthcare needs (CSHN) using appropriate screening tools and assessments. Provides complex case management to members with complex needs. Performs related field work and community engagement travel as needed to increase EPSDT awareness and compliance. May assist with EPSDT policies/procedures and completing service authorizations. Education Associate's degree in Nursing preferred. Bachelor's degree in Health & Human Services-related field or related experience in lieu of education accepted. Licensed Practical Nurse (LPN) or Bachelor's prepared health professional strongly preferred. Certification/Licensure None required Experience MCO/HMO experience

REQUIRED 3

years of clinical experience within the last 5 years 3 years of Medicaid/Medicare experience preferred Familiar with HEDIS measures, EPSDT, and childhood immunizations charts and periodicity schedule. Utilization Management experience and Chart review/audit experience 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-98959

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