Remote Nurse Case Manager I - Care Coordination

Elevance Health (Anthem); Boght Corners (NY); Remote; USD 67,000 - 121,000; Full time

Benefits offered by this job

Comprehensive benefits package

Job summary

Elevance Health invites applications for a Nurse Case Manager I position. This remote role enables full-time telework with occasional in-person training, accommodating a flexible schedule within a defined office-access policy.

The nurse will develop, coordinate, monitor, and evaluate care plans for members with complex needs, performing telephonic discharge planning from hospitals as needed. Requirements include a BA/BS in a health-related field, 3+ years of clinical experience, and an active RN

Qualifications

• Requires BA/BS in a health-related field and minimum of 3 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 Case Manager preferred; compact RN license preferred.

Responsibilities

• Ensure member access to services and develop a care management plan.
• Coordinate authorizations/referrals within benefits structure and through extra-contractual arrangements.
• Coordinate internal and external resources to meet identified needs.
• Monitor and evaluate care management plans and liaise with Medical Directors and Physician Advisors.
• Assist in problem solving with providers, claims or service issues.

Skills

RN license

Multi-state licensure

Case management certification (pref)

Education

BA/BS in health-related field

Job description

Elevance Health invites applications for a Nurse Case Manager I position. This remote role enables full-time telework with occasional in-person training, accommodating a flexible schedule within a defined office-access policy.

The nurse will develop, coordinate, monitor, and evaluate care plans for members with complex needs, performing telephonic discharge planning from hospitals as needed. Requirements include a BA/BS in a health-related field, 3+ years of clinical experience, and an active RN