Remote Nurse Case Manager II — Care Coordination Pro

Elevance Health, Inc.; Columbus (OH); Hybrid; USD 76,000 - 125,000; Full time

Job summary

Elevance Health, Inc. seeks a Nurse Case Manager II to manage complex chronic care needs, assessing and coordinating care plans for members.

The role may involve telephonic or on-site discharge planning and requires an active RN license with multi-state eligibility where applicable. The position supports flexible hybrid/virtual work within reasonable commuting distance and includes comprehensive benefits; salary ranges are provided for in-person locations, with a focus on equity and

Qualifications

• Requires BA/BS in a health related field and minimum of 5 years of clinical experience.
• Current, unrestricted RN license in applicable state(s).
• Multi-state licensure is required if providing services in multiple states.
• Certification as a Case Manager and a BS in a health or human services field is preferred.
• Active Registered Nurse Compact License is highly preferred.

Responsibilities

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

Skills

Case management

Discharge planning

Communication

Multistate licensure

Education

BA/BS in health-related field

RN license (unrestricted)

Job description

Elevance Health, Inc. seeks a Nurse Case Manager II to manage complex chronic care needs, assessing and coordinating care plans for members.

The role may involve telephonic or on-site discharge planning and requires an active RN license with multi-state eligibility where applicable. The position supports flexible hybrid/virtual work within reasonable commuting distance and includes comprehensive benefits; salary ranges are provided for in-person locations, with a focus on equity and