Remote Telephonic Nurse Case Manager

Elevance Health; Latham (NY); Hybrid; USD 71,000 - 111,000; Full time

Benefits offered by this job

Comprehensive benefits package

Incentive programs

Stock purchase plan

401k contribution

Job summary

Elevance Health is seeking a Telephonic Nurse Case Manager I to coordinate care plans for members with complex needs. The role involves assessing, developing, implementing, and monitoring care plans remotely with occasional in-person training and state licensure requirements.

Requires a BA/BS in a health-related field plus 3+ years of clinical experience and an unrestricted RN license; multi-state licensure is required. Hybrid/virtual work is supported with some in-person sessions.

Qualifications

• Requires BA/BS in a health-related field and minimum 3 years of clinical experience.
• Current unrestricted RN license in applicable state(s) required.
• Multi-state licensure is required if this individual provides services in multiple states.

Responsibilities

• Ensures member access to services appropriate to their health needs.
• Conducts assessments to identify needs and a care management plan.
• Implements care plan by facilitating authorizations/referrals within benefits.
• Coordinates internal and external resources to meet needs.
• Monitors and evaluates the care management plan and updates as needed.
• Interacts with Medical Directors and Physician Advisors on care plans.
• Negotiate rates of reimbursement and assist in problem solving with providers.

Skills

Case management

Telephonic care management

Education

BA/BS in a health-related field

RN license (unrestricted)

Job description

Elevance Health is seeking a Telephonic Nurse Case Manager I to coordinate care plans for members with complex needs. The role involves assessing, developing, implementing, and monitoring care plans remotely with occasional in-person training and state licensure requirements.

Requires a BA/BS in a health-related field plus 3+ years of clinical experience and an unrestricted RN license; multi-state licensure is required. Hybrid/virtual work is supported with some in-person sessions.