Remote RN Care Manager - Contract

Elevance Health; United States; Hybrid; USD 38,000 - 72,000; Full time

Job summary

Elevance Health offers a 100% remote contract opportunity for a licensed RN with case management expertise to coordinate care for members with complex needs. You will assess medical necessity, develop and monitor care plans, and collaborate with providers to ensure high-quality, cost-effective care across settings.

The role requires an active RN license, multi-state licensure where applicable, and strong computer skills.

Qualifications

• HS diploma or equivalent with at least 3 years of acute care clinical experience.
• Active RN license in applicable state(s); multi-state licensure if practicing across states.
• Certification as a Case Manager preferred; URAC considerations for licensed areas.
• 3 years direct clinical care experience; 5 years preferred or equivalent background; multi-state licensure if applicable.
• Computer experience required.

Responsibilities

• Ensures medically appropriate, high-quality, cost-effective care by assessing the medical necessity of inpatient admissions, outpatient services, and level of care.
• Partners with physician clinical reviewers and/or medical directors to interpret appropriateness of care and provide clinical guidance.
• Collaborates with providers to assess consumer needs for early discharge planning and care coordination.
• Conducts clinical assessments to develop goals and care plans addressing individual needs and discharge planning.
• Monitors and evaluates effectiveness of the care management plan and makes modifications as needed.
• Telephonic outpatient case management experience and managed care involvement.

Skills

Acute care nursing experience

Case management

Multi-state licensure

Education

High School Diploma or equivalent

BS in health or human services related field preferred

Tools

Computer proficiency

Job description

Elevance Health offers a 100% remote contract opportunity for a licensed RN with case management expertise to coordinate care for members with complex needs. You will assess medical necessity, develop and monitor care plans, and collaborate with providers to ensure high-quality, cost-effective care across settings.

The role requires an active RN license, multi-state licensure where applicable, and strong computer skills.