Remote RN Case Manager - Complex Care Coordination

Elevance Health, Inc.; Mason (OH); Híbrido; USD 64.000 - 101.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Comprehensive benefits

Hybrid work model

Incentive programs

Descripción de la vacante

Elevance Health, Inc. is seeking a Care Manager to perform care management for members with complex and chronic care needs, assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum.

Duties may be telephonically or on-site for discharge planning. The role requires a BA/BS in a health-related field, an active RN license, and multi-state licensure.

Formación

• 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.
• For URAC accredited areas the following applies: Requires BA/BS and 3 years of clinical care experience; or any combination of education and experience, which would provide an equivalent background.

Responsabilidades

• Ensures member access to services appropriate to their health needs
• Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment
• Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through 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 the development of care management treatment plans
• Negotiates rates of reimbursement, as applicable
• Assists in problem solving with providers, claims or service issues

Conocimientos

Care management

RN licensure

Multistate licensure

Educación

BA/BS in health-related field

Descripción del empleo

Elevance Health, Inc. is seeking a Care Manager to perform care management for members with complex and chronic care needs, assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum.

Duties may be telephonically or on-site for discharge planning. The role requires a BA/BS in a health-related field, an active RN license, and multi-state licensure.