Remote Nurse Case Manager II: Care Coordination Pro

Elevance Health; Latham (NY); Hybrid; USD 79,000 - 125,000; Full time

Benefits offered by this job

Comprehensive benefits

401(k) + match

Stock purchase plan

Job summary

Elevance Health is seeking a Nurse Case Manager II to coordinate care for members with complex and chronic needs. This role involves assessing, developing, implementing, coordinating, monitoring, and evaluating care plans to optimize health across the care continuum.

Remote work eligibility with required in-person training sessions. The position emphasizes collaboration with Medical Directors and Physician Advisors, facilitating authorizations and referrals, and ensuring access to appropriate

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) required.
• Multi-state licensure required if providing services in multiple states.

Responsibilities

• Performs discharge planning telephonically or on-site at hospitals.
• Ensures member access to services appropriate to health needs.
• Conducts assessments to identify needs and develops a care management plan.
• Implements care plan by coordinating authorizations/referrals within benefits structure.
• Coordinates internal and external resources to meet identified needs.
• Monitors and evaluates the care management plan and updates as needed.
• Assists with problem solving with providers, claims or service issues.
• Assists with development of utilization/care management policies and procedures.

Skills

Case management

Education

BA/BS in health related field

Job description

Elevance Health is seeking a Nurse Case Manager II to coordinate care for members with complex and chronic needs. This role involves assessing, developing, implementing, coordinating, monitoring, and evaluating care plans to optimize health across the care continuum.

Remote work eligibility with required in-person training sessions. The position emphasizes collaboration with Medical Directors and Physician Advisors, facilitating authorizations and referrals, and ensuring access to appropriate