Remote Nurse Case Manager II — Telehealth Care Plans

Elevance Health; Miami (FL); Remote; USD 76,000 - 125,000; Full time

Job summary

Elevance Health is seeking a Nurse Case Manager II to oversee care management for members with complex and chronic care needs, assessing and coordinating care plans telephonically or on-site, including discharge planning.

The role requires a BA/BS in a health-related field, an active RN license, and at least five years of clinical experience. Multi-state licensure is preferred; hybrid/virtual work includes in-person training and occasional commuting.

Qualifications

• BA/BS in a health related field and minimum 5 years of clinical experience.
• Current, unrestricted RN license in applicable state(s).
• Multi-state licensure required for services in multiple states.

Responsibilities

• Care management for members with complex and chronic needs.
• Assess, develop, implement, coordinate, monitor and evaluate care plans.
• Perform duties telephonically or on-site, including discharge planning.
• Ensure access to services appropriate to health needs.
• Conduct assessments to identify needs and create care plans.
• Facilitate authorizations/referrals within benefits structure.
• Coordinate internal and external resources to meet needs.
• Monitor and adjust care plans; interact with Medical Directors/Physician Advisors.
• Negotiate rates of reimbursement as applicable.
• Assist with problem solving for providers, claims or service issues.
• Support development of utilization/care management policies and procedures.

Skills

Care management

Assessment

Coordination

Discharge planning

Communication

Education

BA/BS in health related field

RN license (state)

Multi-state licensure

Job description

Elevance Health is seeking a Nurse Case Manager II to oversee care management for members with complex and chronic care needs, assessing and coordinating care plans telephonically or on-site, including discharge planning.

The role requires a BA/BS in a health-related field, an active RN license, and at least five years of clinical experience. Multi-state licensure is preferred; hybrid/virtual work includes in-person training and occasional commuting.