Remote Telephonic Nurse Case Manager II

The Elevance Health Companies, Inc.

Indianapolis (IN)

Remote

USD 80,000 - 105,000

Full time

3 days ago

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Job summary

Elevance Health seeks a Telephonic Nurse Case Manager II to support members via telephonic care management. The role offers virtual work with occasional in-person trainings and potential alternate locations within commuting distance.

Requires RN license, BA/BS in health-related field, and 5 years clinical experience; multi-state licensure preferred. In this fast-paced position, you will assess needs, develop care plans, coordinate resources, and work with Medical Directors to optimize member

Qualifications

Requires a BA/BS in a health-related field and minimum 5 years of clinical experience.
Current, unrestricted RN license in applicable state(s) required; multi-state licensure preferred.
URAC-accredited areas require additional qualifications as stated.

Responsibilities

Ensures member access to services appropriate to their health needs.
Conducts assessments to identify needs and creates a care management plan.
Implements care plan by facilitating authorizations/referrals within benefits or extra-contractual arrangements.
Coordinates internal and external resources to meet identified needs.
Monitors and evaluates the care management plan and modifies as necessary.
Interfaces with Medical Directors and Physician Advisors on plan development.
Assists in problem solving with providers.
Assists with development of utilization/care management policies and procedures.