Remote Nurse Case Manager I — Care Coordination

Elevance Health; Virginia (MN); A distancia; USD 71.000 - 106.000; Jornada completa

Descripción de la vacante

Elevance Health seeks a Nurse Case Manager I to assess, develop, coordinate, and evaluate care plans for members with complex and chronic needs. Role supports telephonic or on-site activities, including discharge planning, with hybrid/virtual work arrangements.

The position requires a BA/BS in a health field and 3+ years of clinical experience, plus RN licensure and multi-state eligibility. Salary range for NY is $70,560–$105,840.

Formación

• Requires 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 this individual is providing services in multiple states.

Responsabilidades

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

Conocimientos

RN license

Clinical experience

Multi-state licensure

Educación

BA/BS in health field

Descripción del empleo

Elevance Health seeks a Nurse Case Manager I to assess, develop, coordinate, and evaluate care plans for members with complex and chronic needs. Role supports telephonic or on-site activities, including discharge planning, with hybrid/virtual work arrangements.

The position requires a BA/BS in a health field and 3+ years of clinical experience, plus RN licensure and multi-state eligibility. Salary range for NY is $70,560–$105,840.