Registered Nurse (RN)- Full-Time, day shift (Health Services)

Elevance Health; Colorado Springs (CO); Remoto; USD 70.000 - 110.000; Tempo pieno

Vantaggi offerti da questo lavoro

Comprehensive benefits

Descrizione del lavoro

Nurse Case Mgr II (RN) role at Elevance Health offers virtual, full-time care management for members with complex needs. The position emphasizes risk stratification, planning, implementation, and transition of care to optimize outcomes and access to services.

Ideal candidates hold a BSN/BA in health-related field with RN licensure, 5+ years clinical and 2+ years direct case management experience, and strong MS Office skills. The role includes policy collaboration and telephonic care coordination.

Competenze

• BA/BS in a health-related field and 5+ years of clinical experience.
• Current, unrestricted RN license in applicable state(s).
• Multi-state RN licensure required for providing services in multiple states upon hire.
• Active California RN license is highly preferred.
• Minimum 2 years of direct Case Management experience.
• Telephonic and/or virtual nursing experience.
• Managed Care experience.
• Minimum 2 years’ experience in acute care setting.
• Experience with Microsoft Office suite and ability to learn new computer programs/systems quickly.

Mansioni

• Conducts assessments to identify needs and develops a care management plan.
• Facilitates authorizations/referrals within benefits structure or through extra-contractual arrangements.
• Monitors and evaluates effectiveness of the care plan and adjusts as needed.
• Interfaces with Medical Directors and health professionals on care plans.
• Assists with problem solving with providers, claims or service issues.
• Contributes to development of utilization/care management policies and procedures.

Conoscenze

Telephonic virtual nursing

Managed Care experience

Direct Case Management

Microsoft Office

Formazione

BA/BS in health-related field

Strumenti

Microsoft Office Suite

Descrizione del lavoro

Nurse Case Mgr II (RN) Job Description

Nurse Case Mgr II (RN)

Location

Virtual

This role enables associates to work virtually full-time, except for 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.

Work Shift

Monday – Friday, 9:00 am to 5:30 pm (PST or MST) with 2 evening shifts every week from 11:30 am to 8:00 pm (PST or MST)

The Nurse Case Mgr II (RN) is responsible for care management within the scope of licensure for members with complex and chronic care needs. Care management is conducted through screening, assessing, stratifying risk, planning, implementing (care coordination), following up, transitioning (transitional care), communicating post transition, and evaluating members. Our care model is designed to optimize member health care across the care continuum. We provide meaningful interventions that drive improvements in clinical outcomes, productivity, and quality of life. 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.
• Assists in facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements.
• Monitors and evaluates effectiveness of the care management plan and modifies as necessary.
• Interfaces with Medical Directors and other health professionals on the development of care management treatment plans.
• Assists in problem solving with providers, claims or service issues.
• Assists with development of utilization/care management policies and procedures.

Requirements

• BA/BS in a health related field and minimum of 5 years of clinical experience; Current, unrestricted RN license in applicable state(s) is required.
• Multi-state RN licensure is required for providing services in multiple states upon hire.
• Active California RN license is highly preferred.
• Minimum 2 years of direct Case Management experience.
• Telephonic and/or virtual nursing experience.
• Managed Care experience.
• Minimum 2 years’ experience in acute care setting.
• Experience with Microsoft Office suite and/or ability to learn new computer programs/systems/software quickly.

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 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. 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.

1st Shift (United States of America) Job Family

Licensed Nurse

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.

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 associates. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. Elevance Health will also follow all relevant federal, state, and local laws.

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process should submit the following form:

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.

Workday keeps job postings active through 11:59:59 PM on the day before the listed end date.