Nurse Case Mgr I (US)

Elevance Health (Anthem); Boght Corners (NY); Ibrido; USD 71.000 - 111.000; Tempo pieno

Descrizione del lavoro

Elevance Health is seeking a Nurse Case Manager I to empower members through comprehensive care coordination. The role supports flexible virtual work with occasional in-person training sessions and a commute where applicable.

Salary ranges from $70,560 to $110,880, with benefits and equity opportunities. Multistate licensure may be required for cross-state care and is encouraged for eligibility.

Competenze

• Requires BA/BS in a health-related field and minimum of 3 years of clinical experience.
• Current, unrestricted RN license in applicable state(s) required; multi-state licensure if providing services in multiple states.

Mansioni

• Ensures member access to services appropriate to health needs.
• Conducts assessments to identify needs and a care management plan.
• Implements care plan by facilitating authorizations/referrals within benefits structure or through extra-contractual arrangements.
• Coordinates internal and external resources to meet identified needs.
• Monitors and evaluates effectiveness of the care management plan and modifies as necessary.
• Interfaces with Medical Directors and Physician Advisors on care management plans.
• Negotiates rates of reimbursement as applicable.
• Assists in problem solving with providers, claims or service issues.

Conoscenze

Care coordination

Assessment

Care planning

Negotiation

Formazione

BA/BS in health-related field

RN license

Multi-state licensure

Descrizione del lavoro

Nurse Case Manager I

Location : This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law

How you will make an impact

• Ensures member access to services appropriate to their health needs.
• Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.
• Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements.
• Coordinates internal and external resources to meet identified needs.
• Monitors and evaluates effectiveness of the care management plan and modifies as necessary.
• Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans.
• Negotiates rates of reimbursement, as applicable.
• Assists in problem solving with providers, claims or service issues.

Minimum Requirements

Requires BA/BS in a health related field and minimum of 3 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.

Preferred Skills, Capabilities and Experiences

• Certification as a Case Manager is preferred.
• Certification as a Case Manager and a BS in a health or human services related field preferred.

Salary and Location

For candidates working in person or virtually in the below locations, the salary* range for this specific position is $ 70,560.00-$110,880.00

Location(s): New York, Connecticut

In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.

Job Level

Non-Management Exempt

Job Family

MED > Licensed Nurse

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our as