Remote Nurse Case Manager I – Care Coordination

Elevance Health, Inc.; Boght Corners, Wallingford, Atlanta (NY, CT, GA); Hybrid; USD 71,000 - 111,000; Full time

Job summary

Elevance Health is seeking a Nurse Case Manager I to perform care management for members with complex needs, coordinating plans across the care continuum. The role can be done virtually with required in-person training, with some alternate locations considered within commuting distance of an office.

The incumbent will assess needs, coordinate authorizations and referrals, and work with Medical Directors to optimize care outcomes. Multistate licensure is required if serving multiple states.

Qualifications

• Requires BA/BS in a health related field and a minimum of 3 years of clinical experience; or any combination of education and experience providing an equivalent background.
• Current, unrestricted RN license in applicable state(s) required.
• Multi-state licensure required if providing services in multiple states.

Responsibilities

• Ensures member access to services appropriate to their health needs.
• Conducts assessments to identify individual needs and a specific care management plan.
• Implements care plan by facilitating authorizations/referrals within benefits structure or through extra-contractual arrangements.
• Coordinates internal and external resources to meet identified needs.
• Monitors and evaluates effectiveness of the care management plan and modifies as necessary.
• Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans.

Skills

RN license

Clinical experience

Case management

Education

BA/BS in health-related field

Job description

Elevance Health is seeking a Nurse Case Manager I to perform care management for members with complex needs, coordinating plans across the care continuum. The role can be done virtually with required in-person training, with some alternate locations considered within commuting distance of an office.

The incumbent will assess needs, coordinate authorizations and referrals, and work with Medical Directors to optimize care outcomes. Multistate licensure is required if serving multiple states.