Remote Telephonic Nurse Case Manager II

The Elevance Health Companies, Inc.; Boght Corners (NY); Hybrid; USD 76,000 - 119,000; Full time

Job summary

Elevance Health is seeking a Telephonic Nurse Case Manager II to provide care management across states, primarily remote with required in-person training. The role requires an RN license, multi-state licensure, and 5+ years of clinical experience.

The position involves assessing needs, coordinating care, and interfacing with Medical Directors to optimize member health care. Salary ranges vary by location: $75,680 to $119,196, with benefits and hybrid work arrangements.

Qualifications

• BA/BS in a health-related field with at least 5 years of clinical experience, or equivalent background.
• Current unrestricted RN license in the applicable state.
• Multi-state licensure required for multi-state service delivery.
• Case management experience.
• Certification as a Case Manager.
• At least 2 years’ experience in an acute care setting.
• Experience with Microsoft Office and ability to learn new software quickly.
• Ability to manage and respond to emails promptly.

Responsibilities

• Ensures member access to services appropriate to health needs.
• Conducts assessments to identify needs and develop care plans.
• Facilitates authorizations/referrals within benefits or via extra-contractual arrangements.
• Coordinates internal and external resources to meet needs.
• Monitors and evaluates care plan effectiveness and revises as needed.
• Interacts with Medical Directors/Physician Advisors on care plans.
• Negotiates reimbursement rates when applicable.
• Assists with problem-solving with providers, claims, or service issues.
• Contributes to development of utilization/care management policies.

Skills

Case management

Case manager certification

Microsoft Office

Email/communication management

Education

BA/BS in health-related field

Tools

Microsoft Office

Job description

Elevance Health is seeking a Telephonic Nurse Case Manager II to provide care management across states, primarily remote with required in-person training. The role requires an RN license, multi-state licensure, and 5+ years of clinical experience.

The position involves assessing needs, coordinating care, and interfacing with Medical Directors to optimize member health care. Salary ranges vary by location: $75,680 to $119,196, with benefits and hybrid work arrangements.