Remote Nurse Case Manager II: Care Coordination Leader

Elevance Health; Virginia (MN); Hybrid; USD 72,000 - 119,000; Full time

Job summary

Nurse Case Manager II at Elevance Health in New York is a licensed RN role focused on care coordination, assessments, and developing care management plans for members with complex health needs.

The position is mostly virtual with required in-person training, offers a flexible hybrid schedule, and requires a BA/BS in a health-related field and multi-state licensure where applicable. Salary range for this posting is $79,464 to $119,196, with comprehensive benefits.

Qualifications

• Requires BA/BS in a health related field and minimum of 5 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

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.
• Assists with development of utilization/care management policies and procedures.

Skills

RN licensure

Case management

Care coordination

Assessment & planning

Education

BA/BS in health-related field

Job description

Nurse Case Manager II at Elevance Health in New York is a licensed RN role focused on care coordination, assessments, and developing care management plans for members with complex health needs.

The position is mostly virtual with required in-person training, offers a flexible hybrid schedule, and requires a BA/BS in a health-related field and multi-state licensure where applicable. Salary range for this posting is $79,464 to $119,196, with comprehensive benefits.