Remote Telephonic Nurse Case Manager Lead

Elevance Health; Norfolk (VA); Hybrid; USD 90,000 - 134,000; Full time

Benefits offered by this job

Sign-on bonus

Hybrid work model

Job summary

Elevance Health seeks a Telephonic Nurse Case Manager Lead to coordinate care for members with complex needs. This role works primarily remotely with periodic in-person training and requires an active RN license and 5+ years of clinical experience.

You will assess, develop, implement, and monitor care plans, collaborate with Medical Directors, and lead care management activities across the continuum to improve health outcomes and optimize resource use.

Qualifications

• Requires BA/BS in a health related field and 5 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
• Current, unrestricted RN license in applicable state(s) required.
• Case manager certification required within 3 years of starting in this role.

Responsibilities

• Assess and develop care plans for members with complex needs.
• Coordinate authorizations/referrals within benefits or through extra-contractual arrangements.
• Coordinate internal and external resources to meet identified needs.
• Monitor and evaluate care plans; adjust as necessary.
• Interface with Medical Directors and Physician Advisors on treatment plans.
• Develop and present cases at Grand Rounds/Care Conferences and participate in cross-brand workgroups.

Skills

RN license

Case management

Clinical experience

Care coordination

Education

BA/BS in health related field

BS in health or human services

Case manager certification

Job description

Elevance Health seeks a Telephonic Nurse Case Manager Lead to coordinate care for members with complex needs. This role works primarily remotely with periodic in-person training and requires an active RN license and 5+ years of clinical experience.

You will assess, develop, implement, and monitor care plans, collaborate with Medical Directors, and lead care management activities across the continuum to improve health outcomes and optimize resource use.