Remote Nurse Case Manager II – Care Coordination

The Elevance Health Companies, Inc.; Town of Colonie (NY); Hybrid; USD 79,000 - 119,000; Full time

Benefits offered by this job

Comprehensive benefits package

Equity stock purchase

401k contribution

Paid holidays

Paid Time Off

Merit increases

Job summary

Elevance Health is seeking a Nurse Case Manager II in New York. The role supports care management for members with complex needs, coordinating plans across care settings and performing assessments telephonically or on-site during discharge planning.

Qualified candidates have a BA/BS in a health-related field and an unrestricted RN license, with multi-state licensure preferred. The role offers hybrid work with in-person training and collaboration with Medical Directors and physicians.

Qualifications

• Requires BA/BS in a health-related field or equivalent background.
• Current, unrestricted RN license in applicable state(s) required.
• Multi-state licensure is required if providing services in multiple states.

Responsibilities

• Perform care management within licensure scope for members with complex/ chronic needs.
• Assess, develop, implement, coordinate, monitor, and evaluate care plans.
• Coordinate care with hospitals for discharge planning and services across continuum.
• Facilitate authorizations/referrals within benefits structure or via extra-contractual arrangements.
• Interface with Medical Directors and Physician Advisors on care management plans.
• Negotiate rates of reimbursement as applicable.
• Support policy/procedure development for utilization/care management.

Skills

Care management

Care coordination

Discharge planning

Assessment

Communication

Problem solving

Education

BA/BS in health related field

BS in health or human services related field

Job description

Elevance Health is seeking a Nurse Case Manager II in New York. The role supports care management for members with complex needs, coordinating plans across care settings and performing assessments telephonically or on-site during discharge planning.

Qualified candidates have a BA/BS in a health-related field and an unrestricted RN license, with multi-state licensure preferred. The role offers hybrid work with in-person training and collaboration with Medical Directors and physicians.