Nurse Case Mgr I (US)

IntelliResume; Georgia; On-site; USD 71,000 - 106,000; Full time

Benefits offered by this job

Comprehensive benefits package

Incentive programs

Equity stock purchase

401k contribution

Job summary

IntelliResume in Atlanta, GA is seeking a Nurse Case Manager I to perform care management for members with complex and chronic needs, assessing and coordinating care plans. This role offers flexibility and autonomy while making a meaningful impact on member health.

You will conduct assessments, develop and implement care plans, coordinate resources, monitor progress, and liaise with Medical Directors. A RN license and at least 3 years of clinical experience are required.

Qualifications

• 3+ years of clinical experience required
• RN license in applicable state(s) required
• Multi-state licensure required if providing services in multiple states
• Case Manager certification preferred
• BS in health/human services related field 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.

Skills

Clinical experience

Education

RN license

Multi-state licensure

Case Manager certification

BS in health/human services

Job description

About This Role

The Nurse Case Manager I is responsible for performing 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 those seeking a position that offers flexibility and autonomy while making a significant impact on member health care.

Highlights

• Pay: $70,560 - $105,840/year
• Location: Atlanta, GA
• Schedule: Full-time, M-F 9am-5:30pm with 2-3 late evenings

What You’ll Do

• 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.

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
• BS in a health or human services related field preferred

Benefits

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

About Elevance Health

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