Remote RN Case Manager II

Elevance Health; Virginia Beach (VA); Híbrido; USD 80 000 - 110 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Comprehensive benefits package

Equity stock purchase plan

401k contribution

Performance-based incentives

Resumo da oferta

Elevance Health is seeking a Telephonic Nurse Case Manager II to support members with complex health needs in a largely remote role with occasional in-person training. The position emphasizes clinical judgment, case management expertise, and strong communication.

The role requires an active RN license, CM certification, and 2+ years in acute care, with responsibilities including assessments, care plans, authorizations, and cross-functional collaboration to optimize outcomes.

Qualificações

• Requires BA/BS in a health-related field and at least 5 years of clinical experience.
• Current, unrestricted RN license in applicable state.
• Case Management certification.
• Minimum 2 years’ experience in acute care setting.
• Experience with (Microsoft Office) and/or ability to learn new computer programs/systems/software quickly.
• Ability to manage, review and respond to emails/instant messages in a timely fashion.

Responsabilidades

• Care management for members with complex and chronic needs; develop and monitor care plans.
• Conduct assessments to identify needs and craft care plans.
• Facilitate authorizations/referrals within benefits or via extra-contractual arrangements.
• Monitor and modify care plans based on outcomes.
• Interface with Medical Directors and Physician Advisors on care plans.
• Negotiate reimbursement rates as applicable.
• Assist with problem solving for providers, claims or service issues.
• Contribute to utilization/care management policies and procedures.

Conhecimentos

Case management experience

RN license

Email management

Learning agility

Formação académica

BA/BS in health-related field

Certification as a Case Manager

Ferramentas

Microsoft Office

Descrição da oferta de emprego

Elevance Health is seeking a Telephonic Nurse Case Manager II to support members with complex health needs in a largely remote role with occasional in-person training. The position emphasizes clinical judgment, case management expertise, and strong communication.

The role requires an active RN license, CM certification, and 2+ years in acute care, with responsibilities including assessments, care plans, authorizations, and cross-functional collaboration to optimize outcomes.