Remote Nurse Case Manager I — Care Coordination

Elevance Health; Chicago (IL); Hybrid; USD 71,000 - 88,000; Full time

Benefits offered by this job

Sign-on bonus

Job summary

Elevance Health is seeking a Nurse Case Manager I to perform care management for members with complex and chronic needs, assessing, developing, implementing, coordinating, monitoring, and evaluating care plans. Role can be telephonic or on-site, including discharge planning at hospitals.

Hybrid/virtual work options are available with required in-person training sessions; location is Chicago with salary range stated for onsite/virtual work.

Qualifications

• Requires BA/BS in a health related field and 3 years of clinical experience; RN license current in applicable state(s).
• Multi-state licensure required if providing services in multiple states.
• Certification as a Case Manager is preferred; BS in a health or human services related field is preferred.

Responsibilities

• Ensures member access to services appropriate to health needs.
• Conducts assessments to identify needs and develops a care management plan.
• Implements care plan by facilitating authorizations/referrals within benefits or extra-contractual arrangements.
• Coordinates internal and external resources to meet identified needs.
• Monitors and evaluates effectiveness of the care management plan and modifies it as needed.
• Interfaces with Medical Directors and Physician Advisors on care plans.
• Negotiates rates of reimbursement, as applicable.
• Assists in problem solving with providers, claims or service issues.

Skills

Care management

Assessments

Care coordination

Telephonic communication

RN licensure

Education

BA/BS in health-related field

RN license (multistate licensure)

Certification as Case Manager

BS in health or human services field

Job description

Elevance Health is seeking a Nurse Case Manager I to perform care management for members with complex and chronic needs, assessing, developing, implementing, coordinating, monitoring, and evaluating care plans. Role can be telephonic or on-site, including discharge planning at hospitals.

Hybrid/virtual work options are available with required in-person training sessions; location is Chicago with salary range stated for onsite/virtual work.