Nurse Case Manager I: Care Coordination Specialist

IntelliResume; Missouri; On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Medical, dental, and vision benefits

401(k) + match

Paid Time Off

Merit increases

Paid holidays

Stock purchase plan

Job summary

Elevance Health is seeking a Nurse Case Manager I in St. Louis, MO to perform care management for members with complex and chronic needs.

You will assess, develop, implement, coordinate, monitor, and evaluate care plans in a flexible work environment focused on optimizing member healthcare. Ideal candidates will hold an RN license, have at least 3 years of clinical experience, and be capable of coordinating internal and external resources.

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.
• BS in a health or human services related field preferred.

Responsibilities

• Ensure member access to services appropriate to health needs.
• Conduct assessments to identify 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 effectiveness of care management plans and modify as necessary.
• Interface with Medical Directors and Physician Advisors on care plans.
• Negotiate rates of reimbursement, as applicable.
• Assist in problem solving with providers, claims, or service issues.

Skills

Care coordination

Assessment skills

Education

BA/BS in a health-related field

BS in a health or human services related field

Job description

Elevance Health is seeking a Nurse Case Manager I in St. Louis, MO to perform care management for members with complex and chronic needs.

You will assess, develop, implement, coordinate, monitor, and evaluate care plans in a flexible work environment focused on optimizing member healthcare. Ideal candidates will hold an RN license, have at least 3 years of clinical experience, and be capable of coordinating internal and external resources.