Remote Telephonic Nurse Case Manager I

Elevance Health; Indianapolis (IN); On-site; USD 71,000 - 111,000; Full time

Benefits offered by this job

Comprehensive benefits package

401(k) + match

Equity stock purchase plan

Job summary

Elevance Health is seeking a Telephonic Nurse Case Manager I to manage care plans for members with complex and chronic needs. The role is remote with occasional in-person training, and requires multi-state licensure where applicable.

The candidate will assess, develop, implement, coordinate, monitor, and evaluate care plans telephonically, interfacing with Medical Directors and Physicians. A BA/BS in health and 3+ years of clinical experience plus an RN license are required.

Qualifications

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

Responsibilities

• Ensure member access to services appropriate to their health needs.
• Conduct assessments and develop care management plans.
• Coordinate authorizations/referrals within benefits structure or extra-contractual arrangements.
• Coordinate internal and external resources to meet identified needs.
• Monitor and evaluate care management plan effectiveness and modify as needed.
• Interface with Medical Directors and Physician Advisors on care plans.
• Negotiate reimbursement rates as applicable.
• Assist in problem solving with providers, claims or service issues.

Skills

Clinical experience

RN license

Multi-state licensure

Education

BA/BS in health-related field

Job description

Elevance Health is seeking a Telephonic Nurse Case Manager I to manage care plans for members with complex and chronic needs. The role is remote with occasional in-person training, and requires multi-state licensure where applicable.

The candidate will assess, develop, implement, coordinate, monitor, and evaluate care plans telephonically, interfacing with Medical Directors and Physicians. A BA/BS in health and 3+ years of clinical experience plus an RN license are required.