Remote Nurse Case Manager I - Care Coordination

elevancehealth; St. Louis (MO); Hybrid; USD 65,000 - 90,000; Full time

Job summary

Elevance Health is seeking a Nurse Case Manager I to provide care management for members with complex and chronic conditions. This role assesses, develops, implements, coordinates, monitors, and evaluates care plans to optimize health across the care continuum, performing duties telephonically or on-site when discharge planning is needed.

Work is primarily virtual with required in-person training sessions; alternate locations may be considered near a corporate office.

Qualifications

• Requires BA/BS in a health related field and 3+ years of clinical experience.
• Current, unrestricted RN license in applicable state(s).
• Multistate licensure required for multi-state practice.
• Case management certification and BS in health-related field preferred.
• Ability to perform telephonically or on-site discharge planning.

Responsibilities

• Perform care management for members with complex/ chronic needs.
• Assess, develop, implement, coordinate, monitor, and evaluate care plans.
• Coordinate authorizations/referrals within benefits structure or extra-contractual arrangements.
• Interface with Medical Directors and Physician Advisors on care plans.
• Discharge planning and on-site hospital coordination as needed.
• Negotiate rates of reimbursement where applicable.
• Problem solve with providers, claims or service issues.

Skills

RN licensure

Care coordination

Assessment & care planning

Education

BA/BS in health-related field

RN license (unrestricted)

Job description

Elevance Health is seeking a Nurse Case Manager I to provide care management for members with complex and chronic conditions. This role assesses, develops, implements, coordinates, monitors, and evaluates care plans to optimize health across the care continuum, performing duties telephonically or on-site when discharge planning is needed.

Work is primarily virtual with required in-person training sessions; alternate locations may be considered near a corporate office.