Remote Nurse Case Manager II – Complex Care Coordination

Elevance Health (Anthem); Boght Corners (NY); Hybrid; USD 76,000 - 125,000; Full time

Benefits offered by this job

Comprehensive benefits

Incentives & recognition

Equity stock purchase

401k contribution

Job summary

Elevance Health in New York is seeking a Nurse Case Manager II to provide telephonic care management for members with complex and chronic care needs, assessing, developing, implementing, coordinating, monitoring, and evaluating care plans across the care continuum. This hybrid role requires in-person training sessions and a current, unrestricted RN license (multi-state licensure preferred).

The position offers a comprehensive benefits package and a competitive salary, with emphasis on

Qualifications

• Current, unrestricted RN license in applicable state required.
• Multi-state licensure is required if services are rendered in multiple states.

Responsibilities

• Ensure member access to services appropriate to their health needs.
• Conduct assessments to identify needs and develop a care management plan.
• Implement care plans by facilitating authorizations/referrals as appropriate.
• Coordinate internal and external resources to meet identified needs.
• Monitor and evaluate care plans and modify as necessary.
• Interface with Medical Directors and Physician Advisors on care plans.
• Negotiate rates of reimbursement, as applicable.
• Assist in problem solving with providers, claims or service issues.
• Assist with development of utilization/care management policies.

Skills

Case management

Utilization management

Case manager certification

Acute care experience

Microsoft Office

Email/IM management

Education

RN license

Multi-state licensure

Job description

Elevance Health in New York is seeking a Nurse Case Manager II to provide telephonic care management for members with complex and chronic care needs, assessing, developing, implementing, coordinating, monitoring, and evaluating care plans across the care continuum. This hybrid role requires in-person training sessions and a current, unrestricted RN license (multi-state licensure preferred).

The position offers a comprehensive benefits package and a competitive salary, with emphasis on