Remote Telephonic Nurse Case Manager I

Elevance Health; Latham (NY); Hybrid; USD 67,000 - 116,000; Full time

Job summary

Elevance Health is seeking a Telephonic Nurse Case Manager I to remotely manage care for members with complex needs. The role requires assessing, planning, coordinating, and evaluating care plans via telecommunication, with in-person training sessions as needed.

Minimum qualifications include a BA/BS in a health-related field and an RN license, with multi-state licensure required for multi-state service. Certification in case management and oncology experience are preferred.

Qualifications

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

Responsibilities

• Performs care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans.
• Conducts telephonic assessments to identify needs and develop care management objectives.
• Facilitates authorizations/referrals within benefits structures or through extra-contractual arrangements.
• Coordinates internal and external resources to meet identified needs.
• Monitors and evaluates care plan effectiveness and modifies as necessary.
• Interacts with Medical Directors and Physician Advisors on care management plans; negotiates rates where applicable.

Skills

RN license

Multi-state licensure

Case management certification

Oncology experience

Care management

Education

BA/BS in a health related field

Job description

Elevance Health is seeking a Telephonic Nurse Case Manager I to remotely manage care for members with complex needs. The role requires assessing, planning, coordinating, and evaluating care plans via telecommunication, with in-person training sessions as needed.

Minimum qualifications include a BA/BS in a health-related field and an RN license, with multi-state licensure required for multi-state service. Certification in case management and oncology experience are preferred.