Remote Telephonic Nurse Case Manager II

Elevance Health, Inc.; United States; À distance; USD 79 000 - 119 000; Plein temps

Résumé du poste

Elevance Health is seeking a Telephonic Nurse Case Manager II in New York. The role is remote with occasional in-person training, requiring multi-state licensure and an RN license in the relevant states.

Responsibilities include assessing, planning, coordinating and evaluating care plans for members with complex health needs, coordinating resources and interfacing with medical leadership to ensure quality care delivery.

Qualifications

• Requires BA/BS in a health related field and minimum of 5 years of clinical experience.
• Current, unrestricted RN license in applicable state(s) required.
• Multi-state licensure is required if this individual is providing services in multiple states.

Responsabilités

• Care management within licensure scope for members with complex and chronic care needs.
• Assess, develop, implement, coordinate, monitor and evaluate care plans.
• Coordinate internal and external resources to meet identified needs.
• Monitor and evaluate effectiveness of the care management plan and adjust as necessary.
• Interface with Medical Directors and Physician Advisors on care management plans.
• Negotiate rates of reimbursement as applicable.
• Assist with problem solving with providers, claims or service issues.
• Develop utilization/care management policies and procedures.

Connaissances

RN license

Multi-state licensure

Formation

BA/BS in health-related field

Description du poste

Elevance Health is seeking a Telephonic Nurse Case Manager II in New York. The role is remote with occasional in-person training, requiring multi-state licensure and an RN license in the relevant states.

Responsibilities include assessing, planning, coordinating and evaluating care plans for members with complex health needs, coordinating resources and interfacing with medical leadership to ensure quality care delivery.