Remote Nurse Case Manager I — Care Coordination

Elevance Health; Columbus (GA); Hybrid; USD 67,000 - 105,000; Full time

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. Duties may be telephonically or on-site for discharge planning.

Responsibilities include ensuring access to services, conducting assessments, coordinating authorizations/referrals, and monitoring outcomes.

Qualifications

• 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 is required if providing services in multiple states
• Certification as a Case Manager is preferred

Responsibilities

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

Skills

Care management

Assessment

Coordination

Monitoring

Communication

RN license

Education

BA/BS in health related field

RN license

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. Duties may be telephonically or on-site for discharge planning.

Responsibilities include ensuring access to services, conducting assessments, coordinating authorizations/referrals, and monitoring outcomes.