Remote Nurse Case Manager I — Complex Care Coordination

Elevance Health, Inc.; Indiana; A distancia; USD 65.000 - 90.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Merit increases

Paid holidays

Paid Time Off

Incentive bonus programs

Medical, dental, and vision benefits

Short and long-term disability

401(k) + match

Stock purchase plan

Life insurance

Wellness programs

Financial education resources

Descripción de la vacante

Elevance Health is seeking a Nurse Case Manager I to perform comprehensive care management for members with complex and chronic health needs. The role focuses on assessment, development, implementation, coordination, monitoring, and evaluation of care plans in a flexible work environment.

The incumbent will ensure access to appropriate services, coordinate resources, and work with Medical Directors on treatment plans.

Formación

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

Responsabilidades

• Ensure member access to services appropriate to health needs.
• Conduct assessments to identify needs and develop care management plans.
• Implement care plans by facilitating authorizations/referrals as appropriate.
• Coordinate internal and external resources to meet needs.
• Monitor and evaluate the effectiveness of care management plans and modify as necessary.
• Interface with Medical Directors and Physician Advisors on care management plans.
• Negotiate rates of reimbursement, as applicable.
• Assist in problem solving with providers, claims, or service issues.

Conocimientos

Care coordination

Clinical assessment

Interdisciplinary collaboration

Educación

BA/BS in health-related field

Descripción del empleo

Elevance Health is seeking a Nurse Case Manager I to perform comprehensive care management for members with complex and chronic health needs. The role focuses on assessment, development, implementation, coordination, monitoring, and evaluation of care plans in a flexible work environment.

The incumbent will ensure access to appropriate services, coordinate resources, and work with Medical Directors on treatment plans.