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

Elevance Health; Concord (NC); Hybrid; USD 65,000 - 90,000; Full time

Job summary

Elevance Health is seeking an OB/NICU/PEDs Nurse Case Manager I in North Carolina. This role performs telephonic care management for members with complex and chronic needs, with in-person training required and hybrid/virtual work options. Candidates must reside in North Carolina and hold a current RN license in the state.

The position emphasizes assessment, planning, coordination, monitoring, and collaboration with medical leadership to optimize member health across the care continuum.

Qualifications

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

Responsibilities

• Ensures member access to services appropriate to health needs.
• Conducts assessments to identify needs and develop care management plans.
• Implements care plan by facilitating authorizations/referrals within benefits or 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 care plans.
• Negotiates rates of reimbursement, as applicable.
• Assists in problem solving with providers, claims or service issues.

Skills

RN license

Care coordination

Telephonic care management

Education

BA/BS in health-related field

Job description

Elevance Health is seeking an OB/NICU/PEDs Nurse Case Manager I in North Carolina. This role performs telephonic care management for members with complex and chronic needs, with in-person training required and hybrid/virtual work options. Candidates must reside in North Carolina and hold a current RN license in the state.

The position emphasizes assessment, planning, coordination, monitoring, and collaboration with medical leadership to optimize member health across the care continuum.