Remote RN Case Manager II - Care Coordination

Elevance Health; Colorado Springs (CO); Remote; USD 70.000 - 110.000; Vollzeit

Benefits dieser Stelle

Comprehensive benefits

Zusammenfassung

Nurse Case Mgr II (RN) role at Elevance Health offers virtual, full-time care management for members with complex needs. The position emphasizes risk stratification, planning, implementation, and transition of care to optimize outcomes and access to services.

Ideal candidates hold a BSN/BA in health-related field with RN licensure, 5+ years clinical and 2+ years direct case management experience, and strong MS Office skills. The role includes policy collaboration and telephonic care coordination.

Qualifikationen

• BA/BS in a health-related field and 5+ years of clinical experience.
• Current, unrestricted RN license in applicable state(s).
• Multi-state RN licensure required for providing services in multiple states upon hire.
• Active California RN license is highly preferred.
• Minimum 2 years of direct Case Management experience.
• Telephonic and/or virtual nursing experience.
• Managed Care experience.
• Minimum 2 years’ experience in acute care setting.
• Experience with Microsoft Office suite and ability to learn new computer programs/systems quickly.

Aufgaben

• Conducts assessments to identify needs and develops a care management plan.
• Facilitates authorizations/referrals within benefits structure or through extra-contractual arrangements.
• Monitors and evaluates effectiveness of the care plan and adjusts as needed.
• Interfaces with Medical Directors and health professionals on care plans.
• Assists with problem solving with providers, claims or service issues.
• Contributes to development of utilization/care management policies and procedures.

Kenntnisse

Telephonic virtual nursing

Managed Care experience

Direct Case Management

Microsoft Office

Ausbildung

BA/BS in health-related field

Tools

Microsoft Office Suite

Jobbeschreibung

Nurse Case Mgr II (RN) role at Elevance Health offers virtual, full-time care management for members with complex needs. The position emphasizes risk stratification, planning, implementation, and transition of care to optimize outcomes and access to services.

Ideal candidates hold a BSN/BA in health-related field with RN licensure, 5+ years clinical and 2+ years direct case management experience, and strong MS Office skills. The role includes policy collaboration and telephonic care coordination.