Nurse Case Manager I

Elevance Health; Texas; On-site; USD 71,000 - 88,000; Full time

Benefits offered by this job

Comprehensive benefits package

Incentive and recognition programs

Equity stock purchase and 401k

Job summary

Elevance Health is seeking a Nurse Case Manager I in Grand Prairie, TX to manage complex and chronic care needs. You will assess, develop, implement, coordinate, monitor, and evaluate care plans to improve patient outcomes.

The role offers a full-time schedule, weekday hours, eligibility for a $3,000 sign-on bonus, and a comprehensive benefits package. A current RN license and 3+ years of clinical experience are required.

Qualifications

• Current, unrestricted RN license in applicable state.
• Multi-state licensure preferred if providing services in multiple states.
• BA/BS in a health-related field required.
• Certification as a Case Manager 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 treatment plans.
• Negotiate rates of reimbursement, as applicable.
• Assist in problem solving with providers, claims, or service issues.

Education

BA/BS in health-related field

BA/BS in health-related field

Job description

About This Role

The Nurse Case Manager I is responsible for performing 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 an impact in patient care management.

Highlights

• Pay: $70,560 - $88,200/year
• Location: Grand Prairie, TX
• Schedule: Full-time, Monday - Friday; 9:00am - 5:30pm CST
• Sign-On Bonus: $3,000

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 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

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase and 401k contribution

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.