Remote Telephonic Nurse Case Manager II

Elevance Health; Yorktown (VA); Hybrid; USD 75,000 - 100,000; Full time

Benefits offered by this job

Comprehensive benefits

Equity stock purchase plan

401(k) matching

Performance-based incentives

Job summary

Elevance Health seeks a Telephonic Nurse Case Manager II to coordinate care for members with complex and chronic needs. You will assess, develop, implement, and monitor care plans, ensuring access to services and collaborating with Medical Directors to optimize outcomes.

This virtual role requires BA/BS in a health field, an active RN license, case management certification, and 2+ years in acute care; strong Office skills are essential.

Qualifications

• BA/BS in a health-related field and active RN license.
• Case management experience required.
• Certification as a Case Manager preferred.
• Minimum 2 years’ experience in acute care setting.
• Experience with Microsoft Office and ability to learn systems quickly.
• Ability to manage emails and messages promptly.

Responsibilities

• Assess, develop, implement, coordinate, monitor, and evaluate care plans.
• Ensure member access to services appropriate to health needs.
• Conduct assessments to identify needs and develop care plans.
• Facilitate authorizations/referrals within benefits or extra-contractual arrangements.
• Monitor effectiveness and modify plans as needed.
• Interface with Medical Directors and Physician Advisors on care plans.
• Negotiate rates of reimbursement when applicable.
• Assist with problem solving on providers, claims, or service issues.

Skills

Case management

RN licensure

Acute care experience

BA/BS in health-related field

Certification as Case Manager

Microsoft Office

Education

BA/BS in health-related field

Tools

Microsoft Office

Job description

Elevance Health seeks a Telephonic Nurse Case Manager II to coordinate care for members with complex and chronic needs. You will assess, develop, implement, and monitor care plans, ensuring access to services and collaborating with Medical Directors to optimize outcomes.

This virtual role requires BA/BS in a health field, an active RN license, case management certification, and 2+ years in acute care; strong Office skills are essential.