Nurse Case Manager 1 100% Virtual, Carebridge

Elevance Health; Texas; Remote; USD 70,000 - 90,000; Full time

Benefits offered by this job

Merit increases

Paid holidays

Paid Time Off

Incentive bonus programs

Medical, dental, and vision benefits

Short and long-term disability

Job summary

Elevance Health is seeking a Nurse Case Manager I for a 100% virtual role focused on care management for members with complex and chronic care needs. This position is ideal for experienced nurses looking to impact home and community-based settings.

Highlights include a Grand Prairie, TX base with a full-time schedule from Monday to Friday, 11am–8pm CST. You will perform care management activities, develop care plans, coordinate resources, and collaborate with Medical Directors and Physician

Qualifications

• BA/BS in a health-related field required.
• Minimum of 3 years of clinical experience required.
• Current, unrestricted RN license in applicable state(s) required.
• Multi-state licensure required if providing services in multiple states.
• Certification as a Case Manager preferred.

Responsibilities

• Perform care management within the scope of licensure for members with complex and chronic care needs.
• Conduct assessments to identify individual needs and develop specific care management plans.
• Implement care plans by facilitating authorizations/referrals as appropriate.
• Coordinate internal and external resources to meet identified needs.
• Monitor and evaluate the effectiveness of care management plans and modify as necessary.
• Interface with Medical Directors and Physician Advisors on care management treatment plans.
• Negotiate rates of reimbursement, as applicable.
• Assist in problem solving with providers, claims, or service issues.

Skills

Care coordination

Assessment

Care planning

Interdisciplinary collaboration

Education

RN license (state-appropriate)

Multi-state licensure

Case management certification (preferred)

Job description

The Nurse Case Manager I position is a 100% virtual role focused on care management for members with complex and chronic care needs. This role is ideal for experienced nurses looking to make an impact in home and community-based settings.

Highlights

• Location: Grand Prairie, TX
• Schedule: Full-time, Monday – Friday 11am - 8pm CST

What You'll Do

• Perform care management within the scope of licensure for members with complex and chronic care needs.
• Conduct assessments to identify individual needs and develop specific care management plans.
• Implement care plans by facilitating authorizations/referrals as appropriate.
• Coordinate internal and external resources to meet identified needs.
• Monitor and evaluate the effectiveness of care management plans and modify as necessary.
• Interface with Medical Directors and Physician Advisors on care management treatment plans.
• Negotiate rates of reimbursement, as applicable.
• Assist in problem solving with providers, claims, or service issues.

Requirements

Education:

• BA/BS in a health-related field required.

Experience:

• Minimum of 3 years of clinical experience required.
• Prior case management experience preferred.
• Home health experience preferred.

Licenses & Certifications:

• Current, unrestricted RN license in applicable state(s) required.
• Multi-state licensure required if providing services in multiple states.
• Certification as a Case Manager preferred.

Benefits

• Merit increases
• Paid holidays
• Paid Time Off
• Incentive bonus programs
• Medical, dental, and vision benefits
• Short and long-term disability benefits
• 401(k) + match
• Stock purchase plan
• Life insurance
• Wellness programs
• 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 at all levels who are passionate about making an impact on their members and the communities they serve.