Remote Nurse Case Manager – Virtual Care Coordination

Elevance Health, Inc.; Grand Prairie (TX); Remote; USD 65,000 - 90,000; Full time

Job summary

CareBridge Health, part of Elevance Health, seeks a Nurse Case Manager I for a 100% virtual role. The position involves telephonic and on-site discharge planning duties, with Monday–Friday, 11am–8pm CST hours.

Hybrid/virtual work policy applies, with in-person training sessions and occasional office attendance as needed. The role focuses on managing complex, chronic care needs, coordinating care plans, and interfacing with medical directors to optimize member health across the continuum.

Qualifications

• BA/BS in a health related field and minimum of 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
• Current, unrestricted RN license in applicable state(s) required.
• Multi-state licensure is required if this individual is providing services in multiple states.

Responsibilities

• 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.

Skills

RN license

Multi-state licensure

Education

BA/BS in health related field

Job description

CareBridge Health, part of Elevance Health, seeks a Nurse Case Manager I for a 100% virtual role. The position involves telephonic and on-site discharge planning duties, with Monday–Friday, 11am–8pm CST hours.

Hybrid/virtual work policy applies, with in-person training sessions and occasional office attendance as needed. The role focuses on managing complex, chronic care needs, coordinating care plans, and interfacing with medical directors to optimize member health across the continuum.