Remote Nurse Care Manager I – Bilingual RN

The Elevance Health Companies, Inc.; Puerto Rico; Hybrid; USD 60,000 - 90,000; Full time

Job summary

The Nurse Care Manager I role is based in Puerto Rico with virtual full-time work and required in-person training sessions. This position supports care management for members with complex needs, collaborating with providers to optimize health outcomes.

Multistate licensure is preferred for cross-state services. Ideal candidates possess an RN license, a bilingual English/Spanish capability, and at least 3 years of acute care experience, with strong assessment and care planning skills for diverse

Qualifications

• Requires HS diploma or equivalent and a minimum of 3 years of acute care clinical experience.
• Current, active valid unrestricted RN license in applicable state(s) required.
• Multi-state licensure is required if this individual is providing services in multiple states.

Responsibilities

• Assess medical necessity of inpatient admissions, extensions of stay, and outpatient services to ensure appropriate level of care.
• Collaborate with physician reviewers/medical directors to interpret care appropriateness and planning.
• Work with providers to identify discharge needs and proactive planning.
• Conduct clinical assessments to develop goals and care plans for individual needs.
• Monitor and adjust care management plans based on outcomes.

Skills

RN licensure

Bilingual EN/ES

Acute care experience

Education

HS diploma or equivalent

Job description

The Nurse Care Manager I role is based in Puerto Rico with virtual full-time work and required in-person training sessions. This position supports care management for members with complex needs, collaborating with providers to optimize health outcomes.

Multistate licensure is preferred for cross-state services. Ideal candidates possess an RN license, a bilingual English/Spanish capability, and at least 3 years of acute care experience, with strong assessment and care planning skills for diverse