Integrated Nurse Case Manager, Registered Nurse (RN) – Inpatient and Outpatient Clinical Appeals

Sentara Health

Integrated Nurse Case Manager handling inpatient and outpatient clinical appeals remotely for Sentara Health. Responsible for reviewing clinical denials and analyzing root causes.

Posted 4/22/2026full-timeRemote • Virginia • 🇺🇸 United StatesMid-LevelSeniorWebsite

About the role

Key responsibilities & impact

Manage inpatient and outpatient provider appeals across all payer types, including government and commercial insurance
Review clinical denials (non-billing related), identify root causes, and perform post-claim analysis to support appeal submissions

Requirements

What you’ll need

3 years experience in Nursing REQUIRED
RN-Diploma (Non-degree) REQUIRED; Bachelors Degree in Nursing preferred
Experience/knowledge in Rev Cycle, Utilization Review (UR) and Case Management preferred
Provider appeals experience is a plus
Strong proficiency in Excel

Benefits

Comp & perks

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 may have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

NursingRev CycleUtilization ReviewCase ManagementClinical Denials AnalysisPost-Claim AnalysisProvider Appeals ManagementExcel

Certifications

RN-Diploma