Nurse Case Manager I - Remote Care Coordination

Elevance Health, Inc.; Waukesha (WI); Hybrid; USD 64,000 - 101,000; Full time

Benefits offered by this job

Hybrid work model

Benefits package

Incentive programs

Equity stock purchase

401k contribution

Job summary

Elevance Health is seeking a Care Manager to perform care management for members with complex and chronic needs, assessing, developing and coordinating care plans. Role may be telephonic or on-site, including hospital discharge planning.

You will collaborate with Medical Directors and providers to develop treatment plans, coordinate internal and external resources, and monitor outcomes to ensure appropriate services within benefits.

Qualifications

• Requires BA/BS in a health-related field and minimum of 3 years of clinical experience; or any combination of education and experience that provides an equivalent background.
• Current, unrestricted RN license in applicable state(s) required; multi-state licensure if providing services in multiple states.

Responsibilities

• Performs care management within licensure scope for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans.
• Telephonically or on-site duties such as at hospitals for discharge planning.
• Interfaces with Medical Directors and Physician Advisors on development of care management treatment plans.
• Negotiates rates of reimbursement, as applicable.
• Assists in problem solving with providers, claims or service issues.

Skills

Critical thinking

Teamwork

Communication

Email/instant messaging management

Problem solving with providers/claims

Education

BA/BS in health-related field with 3 years clinical experience

Current, unrestricted RN license

Tools

Microsoft Office

Job description

Elevance Health is seeking a Care Manager to perform care management for members with complex and chronic needs, assessing, developing and coordinating care plans. Role may be telephonic or on-site, including hospital discharge planning.

You will collaborate with Medical Directors and providers to develop treatment plans, coordinate internal and external resources, and monitor outcomes to ensure appropriate services within benefits.