Remote Nurse Case Manager I – Care Coordination & Discharge

The Elevance Health Companies, Inc.; Indianapolis (IN); Hybrid; USD 65,000 - 85,000; Full time

Benefits offered by this job

merit increases

paid holidays

Paid Time Off

incentive bonus programs

medical

dental

vision

short and long term disability

401(k) +match

stock purchase plan

life insurance

wellness programs

financial education resources

Job summary

Elevance Health seeks a Nurse Case Manager I to assess, plan and coordinate care for members with complex needs. The role supports telephonic or on-site care management, including discharge planning and authorizations within the benefits structure.

Strong collaboration with medical directors and providers is essential. Requirements include a BA/BS in a health field, an active RN license, and multi-state licensure as applicable.

Qualifications

• Requires BA/BS in a health related field and minimum of 3 years of clinical experience; or any combination of education and experience providing equivalent background.
• Current, unrestricted RN license in applicable state(s) required.
• Multi-state licensure is required if providing services in multiple states.
• Certification as a Case Manager is preferred.
• Experience with utilization review and/or prior authorization.
• Clinical case management experience in inpatient or outpatient settings.

Responsibilities

• Assess, develop, implement and coordinate care plans for members with complex and chronic needs.
• Perform care management duties telephonically or on-site (e.g., discharge planning).
• Coordinate authorizations/referrals within benefits structure or via extra-contractual arrangements.
• Collaborate with Medical Directors and Physician Advisors on care plans.
• Monitor, evaluate and adjust care plans to optimize health outcomes.
• Communicate effectively with providers, claims teams and members.

Skills

Critical thinking

Communication

Teamwork

Time management

Education

BA/BS in health related field

RN license (unrestricted)

Multi-state licensure

Tools

Microsoft Office

Job description

Elevance Health seeks a Nurse Case Manager I to assess, plan and coordinate care for members with complex needs. The role supports telephonic or on-site care management, including discharge planning and authorizations within the benefits structure.

Strong collaboration with medical directors and providers is essential. Requirements include a BA/BS in a health field, an active RN license, and multi-state licensure as applicable.