Nurse Case Manager II – Remote Care Coordination

The Elevance Health Companies, Inc.; Indianapolis (IN); Hybrid; USD 79,000 - 119,000; Full time

Benefits offered by this job

Comprehensive benefits package

Incentive and recognition programs

Equity stock purchase and 401k

Job summary

The Elevance Health Nurse Case Manager II is a licensed registered nurse responsible for care management of members with complex and chronic needs. This full-time role offers primarily remote work with in-person training and potential office visits, within a hybrid/work-from-home framework.

You will assess, develop, implement, coordinate, monitor and evaluate care plans, engaging with Medical Directors and providers to optimize outcomes.

Qualifications

• Requires BA/BS in a health related field and minimum of 5 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
• Current, unrestricted RN license in applicable state(s) required.
• Multi-state licensure is required if this individual is providing services in multiple states.

Responsibilities

• Performs care management within licensure scope for members with complex and chronic needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans to optimize health care across the continuum.
• Performs duties telephonically or on-site such as at hospitals for discharge planning.
• Ensures member access to services appropriate to their health needs and conducts assessments to identify individual needs and care plan objectives.
• Implements care plan by facilitating authorizations/referrals within benefits structure or through extra-contractual arrangements.
• Coordinates internal and external resources to meet identified needs and monitors/evaluates effectiveness of the care management plan.
• Interfacing with Medical Directors and Physician Advisors on development of care management plans and negotiates rates of reimbursement when applicable.

Skills

Clinical experience

RN license

Education

BA/BS in health-related field

RN license (unrestricted)

Multistate licensure

Job description

The Elevance Health Nurse Case Manager II is a licensed registered nurse responsible for care management of members with complex and chronic needs. This full-time role offers primarily remote work with in-person training and potential office visits, within a hybrid/work-from-home framework.

You will assess, develop, implement, coordinate, monitor and evaluate care plans, engaging with Medical Directors and providers to optimize outcomes.