Remote Nurse Case Manager II — Hybrid

The Elevance Health Companies, Inc.; Atlanta (GA); Remote; USD 85,000 - 105,000; Full time

Job summary

Elevance Health is seeking a Nurse Case Manager II to coordinate care for members with complex needs across multiple states. The role includes telephonic and on-site discharge planning, collaboration with Medical Directors, and development of care plans within benefits structures.

You will require a BA/BS in a health-related field, an RN license, and multi-state licensure eligibility. This is a hybrid/remote role with in-person training sessions as needed.

Qualifications

• Requires BA/BS in a health-related field and minimum of 5 years of clinical experience
• Current, unrestricted RN license in applicable home state required
• Multi-state licensure is required if this individual is providing services in multiple states
• Certification as a Case Manager is preferred

Responsibilities

• Assess and coordinate care plans to optimize member health.
• Perform discharge planning and care coordination telephonically or on-site.
• Coordinate authorizations/referrals within benefits structure.
• Interface with Medical Directors and Physician Advisors on care plans.
• Monitor and evaluate care management effectiveness.
• Develop utilization/care management policies and procedures.
• Negotiate reimbursement rates where applicable.
• Assure member access to appropriate services.
• Collaborate with internal and external resources.

Skills

Clinical experience

Multi-state licensure

Communication skills

Care management

Education

BA/BS in health-related field

RN license

Multi-state licensure eligibility

Job description

Elevance Health is seeking a Nurse Case Manager II to coordinate care for members with complex needs across multiple states. The role includes telephonic and on-site discharge planning, collaboration with Medical Directors, and development of care plans within benefits structures.

You will require a BA/BS in a health-related field, an RN license, and multi-state licensure eligibility. This is a hybrid/remote role with in-person training sessions as needed.