Remote Nurse Case Manager I — Elevate Patient Care & Coordination

Elevance Health (Anthem); Boght Corners (NY); Remote; USD 71,000 - 106,000; Full time

Benefits offered by this job

Comprehensive benefits

Incentive programs

Equity stock purchase

401k contribution

Job summary

Elevance Health is seeking a Nurse Case Manager I in New York to support care management for members with complex and chronic needs. Work involves telephonic or on-site coordination and requires in-person training sessions as needed.

Responsibilities include assessments, developing and monitoring care plans, coordinating authorizations, and collaborating with Medical Directors. RN licensure in applicable states is required; BA/BS in health field and multi-state licensure preferred.

Qualifications

• Requires BA/BS in a health related field and minimum of 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
• Current, unrestricted RN license in applicable state(s) required.
• Multi-state licensure is required if this individual is providing services in multiple states.
• Certification as a Case Manager is preferred.
• Residing in EST/CST preferred.
• Telephonic coaching experience preferred.

Responsibilities

• Establishes access to services aligned with member health needs.
• Reviews assessments to identify needs and develops a care management plan.
• Facilitates authorizations/referrals within benefits or through extra-contractual arrangements.
• Coordinates internal and external resources to meet needs.
• Monitors and evaluates care plan effectiveness and makes adjustments.
• Collaborates with Medical Directors and Physician Advisors on care plans.
• Negotiates rates of reimbursement when applicable.

Skills

RN license

Multi-state licensure

Case management certification

Telephonic coaching experience

Education

BA/BS in health related field

Job description

Elevance Health is seeking a Nurse Case Manager I in New York to support care management for members with complex and chronic needs. Work involves telephonic or on-site coordination and requires in-person training sessions as needed.

Responsibilities include assessments, developing and monitoring care plans, coordinating authorizations, and collaborating with Medical Directors. RN licensure in applicable states is required; BA/BS in health field and multi-state licensure preferred.