Remote Nurse Case Manager I — Care Coordination

Elevance Health; St. Louis (MO); Hybrid; USD 70,000 - 90,000; Full time

Job summary

Elevance Health is seeking a Nurse Case Manager I to perform care management for members with complex needs. The role may be conducted telephonically or on-site, with required in-person training sessions.

The position emphasizes assessments, care plan development, and coordination of services across the continuum to optimize member health outcomes. Hybrid work model applies, with policy-based location requirements.

Qualifications

• BA/BS in a health-related field with a minimum of 3 years of clinical experience.
• Current, unrestricted RN license in applicable state(s).
• Multi-state licensure required if providing services in multiple states.

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 coordinating authorizations/referrals as needed.
• Coordinates internal and external resources to meet identified needs.
• Monitors and evaluates effectiveness of the care plan and updates as necessary.
• Interfaces with Medical Directors and Physician Advisors on care planning.
• Negotiate rates of reimbursement as applicable.
• Assist in problem solving with providers, claims or service issues.

Skills

Care coordination

Discharge planning

Telephonic care management

Education

BA/BS in health-related field

Job description

Elevance Health is seeking a Nurse Case Manager I to perform care management for members with complex needs. The role may be conducted telephonically or on-site, with required in-person training sessions.

The position emphasizes assessments, care plan development, and coordination of services across the continuum to optimize member health outcomes. Hybrid work model applies, with policy-based location requirements.