Nurse Case Manager I

IntelliResume; Missouri; On-site; USD 65,000 - 85,000; Full time

Benefits offered by this job

Sign-On Bonus $3000

Job summary

Elevance Health is seeking a Nurse Case Manager I to perform care management for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans. This role is ideal for experienced nurses looking to make a significant impact on member health care.

Based in St. Louis, MO, you will collaborate with Medical Directors, coordinate authorizations/referrals, and help optimize care delivery while supporting a patient-centered

Qualifications

• BA/BS in a health-related field required.
• Minimum of 3 years of clinical experience required.
• RN license in applicable state(s) required; multi-state licensure may be needed.
• Case Manager certification preferred.

Responsibilities

• Ensure member access to services appropriate to their health needs.
• Conduct assessments to identify individual needs and develop 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.

Education

BA/BS in a health-related field

Current, unrestricted RN license in applicable state(s)

Multi-state licensure

Case Manager certification

Job description

About This Role

The Nurse Case Manager I will perform care management for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans. This role is ideal for experienced nurses looking to make a significant impact on member health care.

Highlights

• Pay:
• Location: St. Louis, MO
• Sign-On Bonus: $3000
• Schedule: Monday - Friday 9:00am - 5:00pm CST

What You'll Do

• Ensure member access to services appropriate to their health needs.
• Conduct assessments to identify individual needs and develop 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

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