Remote Nurse Case Manager II — Multistate Care Coordination

Elevance Health; Mason (OH); Hybrid; USD 70,000 - 90,000; Full time

Benefits offered by this job

Health insurance

Paid time off

401(k) match

Stock purchase plan

Wellness programs

Job summary

Elevance Health is seeking a Nurse Case Manager II to oversee care management for members with complex and chronic conditions, assessing needs and coordinating plans across care settings. The role may involve telephonic work or on-site hospital discharge planning, within licensure scope.

The position requires a BA/BS in a health-related field, an active RN license, and multi-state licensure for multi-state work. We offer a hybrid work model with annual incentives and comprehensive benefits.

Qualifications

• Requires BA/BS in a health-related field.
• Current, unrestricted RN license in applicable home state.
• Multi-state licensure required if providing services in multiple states.

Responsibilities

• Assess, develop, implement, coordinate, monitor, and evaluate care plans for members with complex and chronic needs.
• Perform duties telephonically or on-site (e.g., hospital discharge planning).
• Coordinate internal and external resources to meet identified needs.
• Monitor the care plan effectiveness and modify as needed.
• Interface with Medical Directors and Physician Advisors on care management plans.
• Negotiate reimbursement rates as applicable.
• Assist with problem solving with providers, claims, or service issues.
• Assist with development of utilization/care management policies and procedures.

Skills

RN license

Multi-state licensure

Case management

Education

BA/BS in health-related field

Job description

Elevance Health is seeking a Nurse Case Manager II to oversee care management for members with complex and chronic conditions, assessing needs and coordinating plans across care settings. The role may involve telephonic work or on-site hospital discharge planning, within licensure scope.

The position requires a BA/BS in a health-related field, an active RN license, and multi-state licensure for multi-state work. We offer a hybrid work model with annual incentives and comprehensive benefits.