Nurse Case Mgr II (US)

Elevance Health; Georgia; Remoto; USD 70.000 - 90.000; Tempo pieno

Vantaggi offerti da questo lavoro

Paid holidays

Medical benefits

401(k) with match

Wellness programs

Descrizione del lavoro

Elevance Health seeks a Nurse Case Manager II to manage care for members with complex needs. This full-time position focuses on assessing, developing, and monitoring care plans, allowing experienced nurses to enjoy flexibility and autonomy in a virtual setting.

The role involves collaborating with Medical Directors and facilitating authorizations while ensuring effective care delivery and compliance. Comprehensive benefits include medical, dental, and a 401(k) plan.

Competenze

• Minimum of 5 years of clinical experience required.
• Current, unrestricted RN license in applicable home state required.
• Certification as a Case Manager preferred.

Mansioni

• Assess individual needs and develop specific care management plans.
• Coordinate internal and external resources to meet identified needs.
• Monitor and evaluate the effectiveness of care management plans.

Conoscenze

Care management

Clinical experience

Communication skills

Problem-solving

Formazione

BA/BS in health-related field

Descrizione del lavoro

About This Role

The Nurse Case Manager II is responsible for care management for members with complex and chronic care needs, focusing on assessing, developing, implementing, coordinating, monitoring, and evaluating care plans. This role is ideal for experienced nurses seeking flexibility and autonomy in a virtual work environment.

Highlights

• Location: Atlanta, GA
• Schedule: Full-time, Monday-Friday EST with 1 late evening per week

What You'll Do

• Assess individual needs and develop specific 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 treatment plans.
• Negotiate rates of reimbursement as applicable.
• Assist in problem-solving with providers, claims, or service issues.
• Contribute to 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 home state required
• Multi-state licensure required if providing services in multiple states
• Certification as a Case Manager preferred

Benefits

• Merit increases
• Paid holidays and Paid Time Off
• Medical, dental, and vision benefits
• Short and long-term disability benefits
• 401(k) with match
• Stock purchase plan
• Life insurance
• Wellness programs and financial education resources

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.