Nurse Care Manager I (RN) - Remote/Bilingual

Elevance Health; United States; Hybrid; USD 65,000 - 85,000; Full time

Job summary

Elevance Health is seeking a Nurse Care Manager I (NCLEX) based in or near Puerto Rico with bilingual English/Spanish capabilities. This role focuses on personalized health management and coordinating with providers to improve outcomes for members with complex needs.

The candidate will operate in a bilingual call center environment, with virtual full-time work and occasional in-person training sessions. A flexible location may be considered within commuting distance from the office.

Qualifications

• HS diploma or equivalent with 3 years acute care clinical experience.
• Active, unrestricted RN license in one or more states; multi-state licensure required if practicing in multiple states.
• Fully bilingual in English and Spanish preferred.
• AS or BS in nursing strongly preferred.
• NCLEX certification or current RN license from the US highly preferred.
• Home health or discharge planning experience preferred.
• Case Manager certification or health-related BS is preferred.

Responsibilities

• Ensures medically appropriate, high-quality, cost-effective care by evaluating inpatient admissions, extensions of stay, outpatient services, and appropriate level of care.
• Collaborates with physicians and medical directors to interpret care appropriateness and plan guidance.
• Works with providers to identify patient needs for early discharge planning and transition.
• Performs clinical assessments to develop and implement individualized care plans.

Skills

Bilingual English/Spanish

Care management

Clinical assessment

Discharge planning

Education

RN license (active)

AS or BS in nursing

Job description

Elevance Health is seeking a Nurse Care Manager I (NCLEX) based in or near Puerto Rico with bilingual English/Spanish capabilities. This role focuses on personalized health management and coordinating with providers to improve outcomes for members with complex needs.

The candidate will operate in a bilingual call center environment, with virtual full-time work and occasional in-person training sessions. A flexible location may be considered within commuting distance from the office.