Remote Telephonic Nurse Case Manager II

Elevance Health; St. Louis (MO); Hybride; USD 75 000 - 95 000; Plein temps

Avantages offerts par ce poste

Medical benefits

401(k) + match

Paid time off

Incentive bonus programs

Wellness programs

Résumé du poste

Elevance Health Telephonic Nurse Case Manager II position is a full-time, primarily remote role with in-person training as required. It requires multi-state licensure and an active RN license to service members across states.

You will assess needs, develop care plans, facilitate referrals, monitor outcomes, and collaborate with Medical Directors to optimize care across the continuum. Strong communication and critical thinking are essential.

Qualifications

• Requires BA/BS in a health-related field with equivalent experience.
• Current, unrestricted RN license in applicable state(s).
• Multi-state licensure is required if providing services in multiple states.
• Case Management experience and/or certification preferred.

Responsabilités

• Assess, develop, implement, coordinate, monitor and evaluate care plans to optimize member health across the care continuum.
• Perform duties telephonically to manage care for members with complex needs.
• Ensure access to services aligned with members' health needs.
• Coordinate internal and external resources to meet identified needs.
• Monitor effectiveness of care plans and adjust as needed.
• Collaborate with Medical Directors and Physician Advisors on treatment plans.
• Negotiate rates of reimbursement when applicable.
• Assist with problem solving for providers, claims or service issues.

Connaissances

Case Management experience

Critical thinking

Communication skills

Microsoft Office

Formation

BA/BS in health related field

RN license

Multi-state licensure

Outils

Microsoft Office

Description du poste

Elevance Health Telephonic Nurse Case Manager II position is a full-time, primarily remote role with in-person training as required. It requires multi-state licensure and an active RN license to service members across states.

You will assess needs, develop care plans, facilitate referrals, monitor outcomes, and collaborate with Medical Directors to optimize care across the continuum. Strong communication and critical thinking are essential.