Remote Nurse Case Manager I | Care Coordination

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

Benefits offered by this job

Comprehensive benefits package

Equity stock purchase

401(k) contribution

Incentive programs

Hybrid work arrangement

Job summary

Elevance Health Nurse Case Manager I performs care management within licensure for members with complex and chronic needs, assessing, developing, implementing, coordinating, monitoring and evaluating care plans to optimize health care across the continuum. Duties include telephonic or on-site support such as hospital discharge planning.

The role supports hybrid/virtual work, with in-person onboarding as required.

Qualifications

• BA/BS in a health-related field required.
• Current, unrestricted RN license in applicable state(s).
• Multi-state licensure required if providing services in multiple states.

Responsibilities

• Performs care management within licensure for members with complex and chronic needs.
• Assess, develop, implement, coordinate, monitor and evaluate care plans to optimize member health care across the care continuum.
• Coordinate authorizations/referrals within benefits structure or through extra-contractual arrangements.
• Interface with Medical Directors and Physician Advisors on care management treatment plans.
• Negotiate rates of reimbursement, as applicable.
• Assist in problem solving with providers, claims or service issues.

Skills

RN license

Multi-state licensure

Case Manager certification (preferred)

Education

BA/BS in health-related field

Job description

Elevance Health Nurse Case Manager I performs care management within licensure for members with complex and chronic needs, assessing, developing, implementing, coordinating, monitoring and evaluating care plans to optimize health care across the continuum. Duties include telephonic or on-site support such as hospital discharge planning.

The role supports hybrid/virtual work, with in-person onboarding as required.