Remote Telephonic Nurse Case Manager I

Elevance Health; Atlanta (GA); Hybrid; USD 70,000 - 95,000; Full time

Benefits offered by this job

Merit increases

Paid holidays

Paid Time Off

Incentive bonus programs

Medical insurance

Dental

Vision

Disability insurance (short/long term)

401(k) +match

Stock purchase plan

Life insurance

Wellness programs

Financial education resources

Job summary

Elevance Health is seeking a Telephonic Nurse Case Manager I to provide telephonic care management for members with complex needs. The role requires licensure in Georgia, a BA/BS in a health-related field, and multi-state licensure for service in multiple states.

The position operates under Elevance Health's Hybrid Workforce Strategy with in-person onboarding and training. The role emphasizes coordination of care, assessments, and collaboration with medical directors to optimize member health

Qualifications

• Requires BA/BS in a health-related field.
• 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
• Current, unrestricted RN license from the State of Georgia required.
• Multistate licensure is required if this individual is providing services in multiple states.
• Preferred: Case Manager Certification.

Responsibilities

• Ensures member access to services appropriate to their health needs.
• Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.
• Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements.
• Coordinates internal and external resources to meet identified needs.
• Monitors and evaluates effectiveness of the care management plan and modifies as necessary.
• Interfaces with Medical Directors and Physician Advisor's on the development of care management treatment plans.
• Assists in problem solving with providers, claims or service issues.
• Assists with development of utilization/care management policies and procedures.

Skills

Talk and type

Critical thinking

Time management

Communication

Education

BA/BS in health-related field

RN license (GA)

Tools

Microsoft Office

Job description

Elevance Health is seeking a Telephonic Nurse Case Manager I to provide telephonic care management for members with complex needs. The role requires licensure in Georgia, a BA/BS in a health-related field, and multi-state licensure for service in multiple states.

The position operates under Elevance Health's Hybrid Workforce Strategy with in-person onboarding and training. The role emphasizes coordination of care, assessments, and collaboration with medical directors to optimize member health