Remote Telephonic Nurse Case Manager I

Elevance Health; Wilmington (DE); Hybrid; USD 67,000 - 116,000; Full time

Benefits offered by this job

comprehensive benefits package

incentive and recognition programs

equity stock purchase

401k contribution

Job summary

Elevance Health is seeking a Telephonic Nurse Case Manager I to assess, develop, implement, coordinate, and evaluate patient care plans for members with complex needs. This is a hybrid/virtual role with occasional in-person training and preferred multi-state licensure.

The position requires a BA/BS in a health-related field, an active RN license, and at least 3 years of clinical experience. Salary ranges vary by location and state, with comprehensive benefits offered.

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

• 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 Advisors on the development of care management treatment plans.
• Negotiates rates of reimbursement, as applicable.
• Assists in problem solving with providers, claims or service issues.

Skills

RN license

Multi-state licensure

BA/BS in health field

Case Manager certification

Education

BA/BS in health-related field

Job description

Elevance Health is seeking a Telephonic Nurse Case Manager I to assess, develop, implement, coordinate, and evaluate patient care plans for members with complex needs. This is a hybrid/virtual role with occasional in-person training and preferred multi-state licensure.

The position requires a BA/BS in a health-related field, an active RN license, and at least 3 years of clinical experience. Salary ranges vary by location and state, with comprehensive benefits offered.