Managed Care Coordinator-RN Clinician

Elevance Health, Inc.; Florida; Híbrido; USD 70.000 - 100.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Merit increases

Paid holidays and PTO

Medical, dental, and vision benefits

Short and long-term disability

401(k) with match

Stock purchase plan

Life insurance

Wellness programs

Descripción de la vacante

Elevance Health, Inc. seeks a Managed Care Coordinator - RN Clinician to oversee member case management across the care continuum in a flexible virtual environment. The role includes supervising non-RN clinicians and coordinating services with medical teams, focused on optimizing patient care.

You will perform assessments, develop care plans, and facilitate authorizations while collaborating with the Medical Directors and care teams. Training sessions are in-person as needed.

Formación

• HS diploma or equivalent required.
• Minimum of 3 years in service coordination or case management.
• Current, active RN license in Florida required; state specifics may apply.

Responsabilidades

• Perform telephonic or face-to-face clinical assessments for member needs.
• Identify high-risk members and coordinate care.
• Manage members with chronic illnesses and disabilities.
• Develop individual care plans with member history and goals.
• Collaborate with members, caregivers, and medical directors on plans.
• Supervise non-RN clinicians coordinating services.
• Review performance of non-RN staff and provide input.

Conocimientos

Clinical coordination

Care management

High-risk identification

Communication

Educación

HS diploma

Herramientas

RN license Florida

Descripción del empleo

About This Role

The Managed Care Coordinator - RN Clinician is responsible for the overall management of members' cases within the scope of licensure, providing supervision and direction to non-RN clinicians. This role is ideal for those looking to optimize member healthcare across the care continuum while working in a flexible virtual environment.

Highlights

• Location: Miami, FL
• Schedule: Full-time, Virtual with in-person training sessions

What You'll Do

• Perform telephonic or face-to-face clinical assessments for member needs.
• Identify members for high-risk complications and coordinate care.
• Manage members with chronic illnesses, co-morbidities, and disabilities.
• Obtain thorough and accurate member history to develop individual care plans.
• Establish short and long-term goals in collaboration with members and caregivers.
• Develop care plans for services and ensure member access to those services.
• Facilitate authorizations/referrals for utilization of services as appropriate.
• Interface with Medical Directors and Inter-Disciplinary Teams on care management plans.
• Supervise the work of non-RN clinicians in coordinating services for members.
• Review and provide input on the performance of non-RN clinicians regularly.

Requirements

• Education:
  • HS diploma or equivalent required
• Experience:
  • Minimum of 3 years in Service Coordination, Case Management, or similar role
• Licenses & Certifications:
  • Current, active RN license in Florida required
  • State-specified certification may be required based on state law

Benefits

• Merit increases
• Paid holidays and Paid Time Off
• Medical, dental, and vision benefits
• Short and long-term disability benefits
• 401(k) with match
• Stock purchase planLife insurance
• Wellness programs and financial education resources

About Elevance Health

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. They are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders who are passionate about making an impact on their members and the communities they serve.