Remote Nurse Case Manager I: Care Coordinator

Elevance Health; Tampa (FL); Remote; USD 67,000 - 105,000; Full time

Job summary

Elevance Health is seeking a Nurse Case Manager I to perform care management for members with complex and chronic needs, assessing, developing, implementing, coordinating, monitoring and evaluating care plans designed to optimize member health care across the care continuum. This role may be telephonic or on-site for discharge planning.

RequiredBA/BS in health-related field with 3+ years clinical experience and current, unrestricted RN license (multi-state licensure preferred).

Qualifications

• BA/BS in health-related field with 3+ years clinical experience.
• Current, unrestricted RN license in applicable state(s) required.
• Multi-state licensure required.
• Certification as a Case Manager preferred.

Responsibilities

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

Skills

RN license

Clinical experience

Multi-state licensure

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 and chronic needs, assessing, developing, implementing, coordinating, monitoring and evaluating care plans designed to optimize member health care across the care continuum. This role may be telephonic or on-site for discharge planning.

RequiredBA/BS in health-related field with 3+ years clinical experience and current, unrestricted RN license (multi-state licensure preferred).