Remote OB/NICU/Peds Nurse Case Manager I (RN)

Elevance Health; High Point (NC); Hybrid; USD 70,000 - 95,000; Full time

Job summary

Elevance Health is seeking an RN Case Manager I in North Carolina to perform telephonic care management for members with complex health needs. The role requires a current NC RN license, a BA/BS in a health field, and at least 3 years of clinical experience. The position is hybrid/virtual with mandatory in-person training sessions.

The incumbent will coordinate authorizations, referrals, and resources, monitor care plans, and collaborate with medical directors to optimize member health outcomes.

Qualifications

• Requires BA/BS in a health related field and minimum of 3 years of clinical experience.
• Current, unrestricted RN license in applicable state(s) required.
• Multi-state licensure is required if this individual is providing services in multiple states.
• Certification as a Case Manager is preferred.

Responsibilities

• Ensures member access to services appropriate to their health needs.
• Conducts assessments to identify individual needs and a care management plan.
• Implements care plan by facilitating authorizations/referrals within benefits structure.
• Coordinates internal and external resources to meet identified needs.
• Monitors and evaluates effectiveness of the care management plan.

Skills

RN license

Care management

Assessment

Multi-state licensure

Case management certification

Education

BA/BS in health field

Job description

Elevance Health is seeking an RN Case Manager I in North Carolina to perform telephonic care management for members with complex health needs. The role requires a current NC RN license, a BA/BS in a health field, and at least 3 years of clinical experience. The position is hybrid/virtual with mandatory in-person training sessions.

The incumbent will coordinate authorizations, referrals, and resources, monitor care plans, and collaborate with medical directors to optimize member health outcomes.