Nurse Case Mgr I

Elevance Health; New York (NY); Remote; USD 71,000 - 106,000; Full time

Benefits offered by this job

Comprehensive benefits package

Incentive and recognition programs

401(k) contribution

Equity stock purchase plan

Job summary

Elevance Health is seeking a Nurse Case Manager I to perform care management for members with complex and chronic needs. This role supports coordination in a virtual work environment and involves developing and evaluating care plans.

Shifts include some evenings; location is Latham, NY, with full-time hours and a comprehensive benefits package. Minimum 3 years clinical experience and an active RN license are required, with multi-state licensure as needed.

Qualifications

• BA/BS in a health-related field is required.
• Minimum of 3 years of clinical experience.
• RN license active/unrestricted; multi-state licensure if serving multiple states.
• Case Manager certification preferred.

Responsibilities

• Assess and develop care management plans for members.
• Implement care plans via authorizations and referrals.
• Coordinate internal and external resources to meet identified needs.
• Monitor and evaluate 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 and claims issues.

Skills

Care coordination

Clinical experience

Communication

Education

BA/BS in health-related field

Job description

About This Role

The Nurse Case Manager I is responsible for performing care management for members with complex and chronic care needs. This role is ideal for individuals who thrive in a virtual work environment and are skilled in coordinating and evaluating care plans.

Highlights

• Pay: $70,560 - $105,840/year
• Location: Latham, NY
• Schedule: Full-time, with some evening shifts

What You'll Do

• Assess and develop care management plans for members.
• Implement care plans by facilitating authorizations and 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 and claims issues.

Requirements

Education:

• BA/BS in a health-related field required

Experience:

• Minimum of 3 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

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• 401(k) contribution
• Equity stock purchase plan

About Elevance Health

Elevance Health is a health company dedicated to improving lives and communities while making healthcare simpler. As a Fortune 25 company, they are committed to delivering exceptional patient care and fostering a culture of growth and success for their associates.