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

Hybrid/virtual with in-person training

Career development opportunities

Job summary

Elevance Health is seeking a Telephonic Nurse Case Manager I to deliver care management for members with complex needs entirely by phone, coordinating across the care continuum.

Qualifications include a BA/BS in a health-related field, a current RN license, and multi-state licensure when practicing in several states. A minimum of 3 years of clinical experience is required with preferred Case Manager certification.

Qualifications

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

Responsibilities

• Performs care management telephonically within licensure scope for members with complex and chronic needs.
• Assesses, develops, implements, coordinates, monitors and evaluates care plans to optimize health care.
• Facilitates authorizations/referrals as appropriate and coordinates internal/external resources.
• Monitors effectiveness of care plans and engages with Medical Directors/Physician Advisors.
• Negotiates reimbursement rates as applicable and assists in problem solving with providers.

Skills

Clinical experience

Multistate licensure

Education

BA/BS in health-related field

Job description

Elevance Health is seeking a Telephonic Nurse Case Manager I to deliver care management for members with complex needs entirely by phone, coordinating across the care continuum.

Qualifications include a BA/BS in a health-related field, a current RN license, and multi-state licensure when practicing in several states. A minimum of 3 years of clinical experience is required with preferred Case Manager certification.