Nurse Case Mgr II

IntelliResume; Indiana (PA); On-site; USD 79,000 - 119,000; Full time

Benefits offered by this job

Benefits package

Incentive programs

Stock purchase & 401k

Job summary

Elevance Health is seeking a Nurse Case Manager II for Indianapolis, IN, to manage care for complex and chronic cases in a virtual setting. The role emphasizes assessing, developing, coordinating, and evaluating care plans while collaborating with medical directors and providers.

The successful candidate will have a BA/BS in a health-related field, a current RN license, and at least five years of clinical experience.

Qualifications

• BA/BS in a health-related field is required.
• Minimum of 5 years of clinical experience.
• 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.

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.
• Assist with the development of utilization/care management policies and procedures.

Skills

Care management

Assessment

Coordination

Communication with providers

Education

BA/BS in health-related field

Job description

About This Role

The Nurse Case Manager II 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 individuals who thrive in a virtual environment and are skilled in managing patient care across various settings.

Highlights

• Pay: $79,464 - $119,196/year
• Location: Indianapolis, IN
• Schedule: Full-time, 11:30 AM - 8:00 PM

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.
• Assist with the development of utilization/care management policies and procedures.

Requirements

• Education:
  • BA/BS in a health‑related field required
• Experience:
  • Minimum of 5 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
• 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.