Remote Nurse Case Manager I — Flexible Schedule

Elevance Health; Latham (AL); Hybrid; USD 71,000 - 106,000; Full time

Benefits offered by this job

Comprehensive benefits package

401(k) + match

Job summary

Elevance Health Nurse Case Manager I coordinates member care, conducts assessments, and develops care plans to address identified objectives and goals. You will facilitate authorizations/referrals, coordinate resources, and monitor outcomes with input from medical leadership.

This hybrid/virtual role supports flexible work arrangements and in-person training; requires an RN license, a BA/BS in a health-related field, and may require multi-state licensure to serve across states.

Qualifications

• BA/BS in health related field and minimum of 3 years of clinical experience; or equivalent background.
• Current, unrestricted RN license in applicable state(s) required.
• Multi-state licensure required if providing services in multiple states.

Responsibilities

• Ensures member access to services appropriate to their health needs.
• Conducts assessments to identify needs and develops a care management plan.
• Implements care plan by facilitating authorizations/referrals within benefits.
• Coordinates internal and external resources to meet identified needs.
• Monitors and evaluates effectiveness of the care plan and adjusts as needed.
• Interfaces with Medical Directors and Physician Advisors on treatment plans.
• Negotiates rates of reimbursement, as applicable.
• Assists in problem solving with providers, claims or service issues.

Skills

RN license

Case management

Assessment skills

Education

BA/BS in health related field

Job description

Elevance Health Nurse Case Manager I coordinates member care, conducts assessments, and develops care plans to address identified objectives and goals. You will facilitate authorizations/referrals, coordinate resources, and monitor outcomes with input from medical leadership.

This hybrid/virtual role supports flexible work arrangements and in-person training; requires an RN license, a BA/BS in a health-related field, and may require multi-state licensure to serve across states.