Nurse Case Manager - Impactful Care Coordination (Mon-Fri)

IntelliResume; Missouri; On-site; USD 65,000 - 85,000; Full time

Benefits offered by this job

Sign-On Bonus $3000

Job summary

Elevance Health is seeking a Nurse Case Manager I to perform care management for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans. This role is ideal for experienced nurses looking to make a significant impact on member health care.

Based in St. Louis, MO, you will collaborate with Medical Directors, coordinate authorizations/referrals, and help optimize care delivery while supporting a patient-centered

Qualifications

• BA/BS in a health-related field required.
• Minimum of 3 years of clinical experience required.
• RN license in applicable state(s) required; multi-state licensure may be needed.
• Case Manager certification preferred.

Responsibilities

• Ensure member access to services appropriate to their health needs.
• Conduct assessments to identify individual 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 the effectiveness of care management plans 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.

Education

BA/BS in a health-related field

Current, unrestricted RN license in applicable state(s)

Multi-state licensure

Case Manager certification

Job description

Elevance Health is seeking a Nurse Case Manager I to perform care management for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans. This role is ideal for experienced nurses looking to make a significant impact on member health care.

Based in St. Louis, MO, you will collaborate with Medical Directors, coordinate authorizations/referrals, and help optimize care delivery while supporting a patient-centered