Nurse Case Manager II — Complex-Care Coordinator (Atlanta)

IntelliResume

Georgia

On-site

USD 85,000 - 115,000

Full time

3 days ago
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Benefits offered by this job

401(k) with match
Stock purchase plan
Medical, dental, and vision benefits
Paid holidays and PTO
Disability benefits
Wellness programs
Life insurance

Job summary

Elevance Health, based in Atlanta, GA, seeks a Nurse Case Manager II to oversee care management for members with complex and chronic needs. You will assess, develop, implement, coordinate, monitor, and evaluate care plans to optimize health outcomes.

The role requires a BA/BS in a health-related field, an active RN license, and multi-state licensure if applicable. A Case Manager certification is preferred. This full-time position includes EST hours and collaboration with medical leadership.

Qualifications

  • BA/BS in a health-related field required.
  • Minimum of 5 years of clinical experience required.
  • Current, unrestricted RN license in applicable home state required.
  • Multi-state licensure required if providing services in multiple states.
  • Certification as a Case Manager preferred.

Responsibilities

  • Assess individual needs and develop specific care management plans.
  • Implement care plans by facilitating authorizations/referrals.
  • Coordinate internal and external resources to meet identified needs.
  • Monitor and evaluate the effectiveness of care management plans.
  • 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.
  • Assist with the development of utilization/care management policies and procedures.

Skills

Care management
Interdisciplinary collaboration
Communication skills
Problem solving

Education

BA/BS in health-related field

Job description

Elevance Health, based in Atlanta, GA, seeks a Nurse Case Manager II to oversee care management for members with complex and chronic needs. You will assess, develop, implement, coordinate, monitor, and evaluate care plans to optimize health outcomes.

The role requires a BA/BS in a health-related field, an active RN license, and multi-state licensure if applicable. A Case Manager certification is preferred. This full-time position includes EST hours and collaboration with medical leadership.

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