Nurse Case Manager II

Elevance Health; Indiana; On-site; USD 76,000 - 125,000; Full time

Benefits offered by this job

Comprehensive benefits package

Incentive programs

Equity stock purchase and 401k

Job summary

Elevance Health, Inc. is seeking a Nurse Case Manager II in Indianapolis to oversee care management for members with complex and chronic needs. You will assess, develop, implement, and monitor care plans to optimize health outcomes and coordinate with providers and payers.

The role requires active RN licensure, at least 5 years of clinical experience, and a BA/BS in a health-related field. Strong collaboration and problem-solving skills are essential for success.

Qualifications

• BA/BS in a health-related field required.
• Minimum of 5 years of clinical experience.
• Current, unrestricted RN license in applicable state(s) required; multi-state licensure preferred.

Responsibilities

• Ensure member access to services appropriate to their health needs.
• Conduct assessments to identify individual needs and develop a specific care management plan.
• Implement care plans by facilitating authorizations/referrals as appropriate.
• Coordinate internal and external resources to meet identified needs.
• Monitor and evaluate the effectiveness of the care management plan 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.
• Assist with the development of utilization/care management policies and procedures.

Skills

Clinical experience

Care management

Interdisciplinary coordination

Education

BA/BS in health-related field

Job description

About This Role

The Nurse Case Manager II is responsible for care management for members with complex and chronic care needs, focusing on assessing, developing, implementing, coordinating, monitoring, and evaluating care plans to optimize member health care.

Highlights

• Pay:$75,680 - $124,872/year
• Location:Indianapolis, IN
• Schedule:Full-time, Monday – Friday; 4 days a week 9AM – 5:30 PM; 1 day a week 11:30AM – 8PM

What You'll Do

• Ensure member access to services appropriate to their health needs.
• Conduct assessments to identify individual needs and develop a specific care management plan.
• Implement care plans by facilitating authorizations/referrals as appropriate.
• Coordinate internal and external resources to meet identified needs.
• Monitor and evaluate the effectiveness of the care management plan 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.
• Assist with the development of utilization/care management policies and procedures.

Requirements

Education:

• BA/BS in a health-related field required

Experience:

• Minimum of 5 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
• Active Registered Nurse Compact License highly 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.