Remote Nurse Case Manager I: Care Coordination

Elevance Health; Latham (NY); Hybrid; USD 71,000 - 106,000; Full time

Job summary

Elevance Health in New York is seeking a Nurse Case Manager I to perform care management for members with complex needs, assessing, coordinating, and evaluating care plans. The role may involve telephonic work or on-site discharge planning.

Work schedule is M-F 9am-5:30pm with occasional late evenings; hybrid/virtual with in-person trainings. Requires RN license and multi-state licensure; salary range is $70,560-$105,840 plus benefits.

Qualifications

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

Responsibilities

• Ensures member access to services appropriate to their health needs.
• Conducts assessments to identify needs and develop a care management plan.
• Implements care plan by facilitating authorizations/referrals within benefits 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 care management plans.
• Negotiates rates of reimbursement, as applicable.
• Assists in problem solving with providers, claims or service issues.

Skills

RN license

Multi-state licensure

Care management

Discharge planning

Education

BA/BS in health-related field

Job description

Elevance Health in New York is seeking a Nurse Case Manager I to perform care management for members with complex needs, assessing, coordinating, and evaluating care plans. The role may involve telephonic work or on-site discharge planning.

Work schedule is M-F 9am-5:30pm with occasional late evenings; hybrid/virtual with in-person trainings. Requires RN license and multi-state licensure; salary range is $70,560-$105,840 plus benefits.