Remote Telephonic Nurse Case Manager II

Elevance Health; Atlanta (GA); Híbrido; USD 79.000 - 119.000; Jornada completa

Descripción de la vacante

Elevance Health is seeking a Telephonic Nurse Case Manager II to coordinate care for members with complex chronic needs. The role conducts assessments, develops care plans, and coordinates authorizations and referrals to optimize health outcomes across the care continuum, primarily telephonically.

Requirements include a BA/BS in a health-related field, RN license (multi-state licensure), and 2+ years in acute care.

Formación

• BA/BS in a health-related field is required.
• Current, unrestricted RN license; multi-state licensure required if servicing multiple states.
• Certification as a Case Manager is preferred.
• Minimum 2 years’ experience in acute care setting preferred.
• Managed Care experience preferred.

Responsabilidades

• Assess members and develop care management plans to optimize health care across the care continuum.
• Coordinate authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements.
• Monitor and evaluate care plans and modify as necessary.
• Interface with Medical Directors and Physician Advisors on care plans.
• Negotiate rates of reimbursement where applicable.
• Assist with problem solving with providers, claims or service issues.
• Assist with development of utilization/care management policies and procedures.

Conocimientos

Critical thinking

Microsoft Office

Multi-tasking

Communication

Time management

Educación

BA/BS in health-related field

Herramientas

Microsoft Office

Descripción del empleo

Elevance Health is seeking a Telephonic Nurse Case Manager II to coordinate care for members with complex chronic needs. The role conducts assessments, develops care plans, and coordinates authorizations and referrals to optimize health outcomes across the care continuum, primarily telephonically.

Requirements include a BA/BS in a health-related field, RN license (multi-state licensure), and 2+ years in acute care.