Remote RN: Acute Inpatient Care Management

Elevance Health; Decatur (GA); Hybrid; USD 85,000 - 110,000; Full time

Benefits offered by this job

Remote work option

Job summary

Elevance Health is seeking a nurse case manager to analyze member clinical information, interface with providers, and apply clinical guidelines to determine medical necessity. You will collaborate on discharge planning and resource optimization while supporting Medical Director on complex cases.

Requirements include an active RN license, 4+ years in care/case management, and multi-state licensure as needed. This is a remote-friendly, hybrid role with potential onsite requirements within the U.S.

Qualifications

• Requires an associate's degree in nursing.
• Minimum 4 years care/case management experience; 2 years clinical/utilization review or managed care experience.
• Active, valid, unrestricted RN license; multi-state licensure if practicing in multiple states.

Responsibilities

• Analyze members' clinical information using nursing judgment and guidelines.
• Collaborate with healthcare providers to promote quality outcomes and appropriate resource use.
• Participate in discharge planning and case-management initiatives.
• Consult with Medical Director on complex cases and recommend care alternatives.

Skills

Nursing judgment

Communication skills

Critical thinking

Education

Associate's degree in nursing

Tools

InterQual

Job description

Elevance Health is seeking a nurse case manager to analyze member clinical information, interface with providers, and apply clinical guidelines to determine medical necessity. You will collaborate on discharge planning and resource optimization while supporting Medical Director on complex cases.

Requirements include an active RN license, 4+ years in care/case management, and multi-state licensure as needed. This is a remote-friendly, hybrid role with potential onsite requirements within the U.S.