Remote RN Case Manager II: Care Coordination Lead

Elevance Health; Carson City (NV); Remote; USD 85,000 - 105,000; Full time

Benefits offered by this job

Hybrid workforce

Wellness programs

401(k) + match

Stock purchase plan

Paid holidays

Job summary

Elevance Health seeks a Nurse Case Manager II (RN) to manage care for members with complex and chronic needs. Responsibilities include screening, assessing, planning and coordinating care, with emphasis on transitions and post-transition follow-up.

Role requires an active RN license (multi-state preferred) and 2+ years in case management or telephonic/virtual nursing. The position supports a hybrid/virtual work model with required in-person training as needed.

Qualifications

• BA/BS in a health-related field and RN license in applicable state(s) required.
• Multi-state RN licensure required for providing services in multiple states.
• Active California RN license is highly preferred.

Responsibilities

• Conduct assessments to identify needs and develop a care management plan.
• Facilitate authorizations/referrals within benefits structure or via extra-contractual arrangements.
• Monitor and adjust the care management plan for effectiveness.
• Interface with Medical Directors and health professionals on care plans.
• Assist with problem solving with providers, claims or service issues.
• Assist with development of utilization/care management policies and procedures.

Skills

Telephonic nursing

Virtual care management

Care coordination

Education

BA/BS in health-related field

RN license (unrestricted)

Multi-state RN licensure

Tools

Microsoft Office

Job description

Elevance Health seeks a Nurse Case Manager II (RN) to manage care for members with complex and chronic needs. Responsibilities include screening, assessing, planning and coordinating care, with emphasis on transitions and post-transition follow-up.

Role requires an active RN license (multi-state preferred) and 2+ years in case management or telephonic/virtual nursing. The position supports a hybrid/virtual work model with required in-person training as needed.