Remote RN Case Manager II (Multi-State Licensure)

Elevance Health; California City (CA); Remote; USD 79,000 - 131,000; Full time

Job summary

Elevance Health is seeking a Nurse Case Manager II (RN) to provide telephonic care management for members with complex and chronic conditions. The role is 100% telephonic with occasional required in-person training, and supports a multi-state licensure requirement upon hire.

The position is remote, with a shift pattern Mon-Fri and two evening shifts; salary range indicated for California/other listed locations.

Qualifications

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

Responsibilities

• Ensures member access to services appropriate to their health needs.
• Conducts assessments to identify needs and develops a care management plan.
• Facilitates authorizations/referrals within benefits structure or via extra-contractual arrangements.
• Coordinates internal and external resources to meet identified needs.
• Monitors and evaluates effectiveness of the care management 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.

Skills

Telephonic nursing

Case management

Managed care

Acute care

MS Office

Education

BA/BS in health-related field

RN license (Current, unrestricted)

Multi-state RN licensure

Job description

Elevance Health is seeking a Nurse Case Manager II (RN) to provide telephonic care management for members with complex and chronic conditions. The role is 100% telephonic with occasional required in-person training, and supports a multi-state licensure requirement upon hire.

The position is remote, with a shift pattern Mon-Fri and two evening shifts; salary range indicated for California/other listed locations.