Remote Nurse Case Manager II - Multistate Licensure

Elevance Health; United States; Remote; USD 76.000 - 119.000; Vollzeit

Benefits dieser Stelle

Comprehensive benefits

Incentive programs

401(k) matching

Zusammenfassung

Elevance Health is seeking a Telephonic Nurse Case Manager II to coordinate care for members with complex needs. The role involves telephonic care management across multiple states, requiring a BA/BS in a health-related field, 5+ years of clinical experience, and an unrestricted RN license with multi-state licensure.

Must be able to conduct assessments, develop and implement care plans, and coordinate with internal/external resources.

Qualifikationen

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

Aufgaben

• Ensures member access to services appropriate to their health needs.
• Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.
• Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements.
• Coordinates internal and external resources to meet identified needs.
• Monitors and evaluates effectiveness of the care management plan and modifies as necessary.
• Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans.
• Negotiates rates of reimbursement, as applicable.
• Assists in problem solving with providers, claims or service issues.
• Assists with development of utilization/care management policies and procedures.

Kenntnisse

Clinical experience

RN license

Multi-state licensure

Microsoft Office

Ausbildung

BA/BS in health-related field

Tools

Microsoft Office

Jobbeschreibung

Elevance Health is seeking a Telephonic Nurse Case Manager II to coordinate care for members with complex needs. The role involves telephonic care management across multiple states, requiring a BA/BS in a health-related field, 5+ years of clinical experience, and an unrestricted RN license with multi-state licensure.

Must be able to conduct assessments, develop and implement care plans, and coordinate with internal/external resources.