Bilingual RN Care Management Supervisor – Hybrid PR

Elevance Health (Anthem); San Juan (PR); Hybrid; USD 90,000 - 115,000; Full time

Job summary

Elevance Health in San Juan, Puerto Rico, is seeking a Manager I Care Management to lead care management operations in a hybrid setting. The role requires a BS in Nursing, an active RN license, and strong clinical leadership experience to drive program quality and risk management.

The incumbent will oversee policy adherence, budget targets, and staff development while working 3 days in-office and 2 days remote. Fluency in English and Spanish is highly preferred and URAC requirements may apply.

Qualifications

• Requires BS in Nursing and a minimum of 5 years of acute care clinical experience
• Current unrestricted RN license in applicable state(s)
• URAC accreditation related requirements may apply and certification as Case Manager is preferred

Responsibilities

• Assesses medical necessity of outpatient services and appropriateness of treatment settings
• Oversees process improvement, quality assurance, and adherence to medical policy and standards
• Ensures prevention and health management program accreditation standards are achieved
• Participates in establishing strategic plans and objectives and develops related policies
• Participates in managing annual budget productivity targets
• Hires, trains, coaches, and evaluates performance of direct reports

Skills

Bilingual English & Spanish

Education

BS in Nursing

RN license

Job description

Elevance Health in San Juan, Puerto Rico, is seeking a Manager I Care Management to lead care management operations in a hybrid setting. The role requires a BS in Nursing, an active RN license, and strong clinical leadership experience to drive program quality and risk management.

The incumbent will oversee policy adherence, budget targets, and staff development while working 3 days in-office and 2 days remote. Fluency in English and Spanish is highly preferred and URAC requirements may apply.