Remote Telephonic Nurse Case Manager II - Care Coordination

Elevance Health; Norfolk (VA); Hybrid; USD 76,000 - 119,000; Full time

Job summary

Elevance Health is seeking a Telephonic Nurse Case Manager II to manage care for members with complex needs. This role works telephonically with occasional in-person training, serving multiple states including New York and Virginia.

Requires RN licensure, a health-related BA/BS, and at least five years of clinical experience; multi-state licensure is required. The position is hybrid with salaried compensation and benefits.

Qualifications

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

Responsibilities

• Assess and develop care plans for members with complex and chronic care needs.
• Coordinate authorizations/referrals within benefits structure or via extra-contractual arrangements.
• Coordinate internal and external resources to meet identified needs.
• Monitor and evaluate effectiveness of the care plan and modify as needed.
• Interface with Medical Directors and Physician Advisors on care management plans.
• Assist in problem solving with providers, claims or service issues.
• Develop utilization/care management policies and procedures.

Skills

Case management experience

Certification as a case manager

Acute care experience

Education

BA/BS in health-related field

Tools

Microsoft Office

Job description

Elevance Health is seeking a Telephonic Nurse Case Manager II to manage care for members with complex needs. This role works telephonically with occasional in-person training, serving multiple states including New York and Virginia.

Requires RN licensure, a health-related BA/BS, and at least five years of clinical experience; multi-state licensure is required. The position is hybrid with salaried compensation and benefits.