Remote Telephonic Nurse Case Manager I

Elevance Health; Norfolk (VA); Remote; USD 67,000 - 116,000; Full time

Benefits offered by this job

Comprehensive benefits package

Incentive programs

Equity stock purchase & 401k

Job summary

Elevance Health is seeking a Telephonic Nurse Case Manager I to provide remote care management for members with complex and chronic conditions. The role requires a BA/BS in a health-related field, a current RN license, and multi-state licensure where applicable.

Typical schedule is Mon–Fri with some evening obligations, and in-person onboarding sessions may be required. The position emphasizes coordination of care, collaboration with medical directors, and navigation of authorizations and

Qualifications

• Requires BA/BS in a health related field and minimum of 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
• 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 telephonic care management within licensure scope for members with complex and chronic care needs.
• Assesses, develops, implements, coordinates, monitors, and evaluates care plans to optimize member health care across the care continuum.
• Facilitates authorizations/referrals within benefits structure or through extra-contractual arrangements.
• Coordinates internal and external resources to meet identified needs.
• Monitors and evaluates the effectiveness of care management plans and modifies as necessary.
• Interfaces with Medical Directors and Physician Advisors on care management plans.
• Negotiates rates of reimbursement where applicable.
• Assists in problem solving with providers, claims or service issues.

Education

BA/BS in health related field

Job description

Elevance Health is seeking a Telephonic Nurse Case Manager I to provide remote care management for members with complex and chronic conditions. The role requires a BA/BS in a health-related field, a current RN license, and multi-state licensure where applicable.

Typical schedule is Mon–Fri with some evening obligations, and in-person onboarding sessions may be required. The position emphasizes coordination of care, collaboration with medical directors, and navigation of authorizations and