Remote RN Care Coordinator — Managed Care

The Elevance Health Companies, Inc.; Miami (FL); Hybrid; USD 70,000 - 95,000; Full time

Job summary

Elevance Health, Inc. is seeking a Managed Care Coordinator-RN Clinician to oversee members' care plans and coordinate multidisciplinary teams. The role emphasizes clinical assessments, care management, and collaboration with physicians and care managers.

The position requires a Florida resident with eligibility for in-person training sessions and hybrid/virtual work. Strong preference for HIV experience and bilingual abilities.

Qualifications

• HS diploma or equivalent required with minimum 3 years of experience in working with individuals with chronic illnesses or disabilities in a service coordination or case management role.
• Current, active RN license in applicable state(s) required.
• HIV experience highly preferred; bilingual Spanish/English or Creole/English desired.
• State-specific certification may be required by law or contract.

Responsibilities

• Perform telephonic or face-to-face clinical assessments to identify, evaluate, coordinate and manage members' health needs.
• Identify high-risk members and coordinate care with the member and health care team.
• Manage members with chronic illnesses to ensure cost-effective and efficient utilization of health benefits.
• Develop and monitor individualized care plans with short- and long-term goals.
• Coordinate authorizations/referrals for services within benefits structure or through extra-contractual arrangements.

Skills

Clinical assessments

Care coordination

RN supervision

Interdisciplinary collaboration

Care planning

Education

Active RN license

HS diploma or equivalent

Job description

Elevance Health, Inc. is seeking a Managed Care Coordinator-RN Clinician to oversee members' care plans and coordinate multidisciplinary teams. The role emphasizes clinical assessments, care management, and collaboration with physicians and care managers.

The position requires a Florida resident with eligibility for in-person training sessions and hybrid/virtual work. Strong preference for HIV experience and bilingual abilities.