Remote Telephonic Nurse Case Manager Lead — Impact

Elevance Health; St. Louis (MO); Híbrido; USD 90.000 - 134.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Sign-on bonus

Descripción de la vacante

Elevance Health is hiring a Telephonic Nurse Case Manager Lead to oversee care management for members with complex needs. This hybrid/remote role emphasizes assessment, coordination, and evaluation of care plans, with on-site training sessions as required.

The position offers a sign-on bonus and a salary range of $89,520–$134,280 for Virginia locations. The ideal candidate holds a BA/BS in health-related field, RN licensure, and case management certification within 3 years.

Formación

• Requires BA/BS in a health-related field and 5 years of clinical experience.
• Current, unrestricted RN license in applicable state(s) required.
• Case manager certification required within 3 years of starting in this role.

Responsabilidades

• Conducts assessments to identify individual needs and develop a specific care management plan.
• Implements care plan by facilitating authorizations/referrals within benefits structure or through extra-contractual arrangements.
• Coordinates internal and external resources to meet identified needs.
• Monitors and evaluates effectiveness of the care management plan and modifies as necessary.
• Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans.
• Negotiates rates of reimbursement, as applicable.
• Assists in problem solving with providers, claims or service issues.
• Develops training materials, completes quality audits, and participates in audits and process reviews.
• Acts as first line contact for conflict resolution.

Conocimientos

RN license

Leadership

Care coordination

Assessment

Educación

BA/BS in health-related field

Descripción del empleo

Elevance Health is hiring a Telephonic Nurse Case Manager Lead to oversee care management for members with complex needs. This hybrid/remote role emphasizes assessment, coordination, and evaluation of care plans, with on-site training sessions as required.

The position offers a sign-on bonus and a salary range of $89,520–$134,280 for Virginia locations. The ideal candidate holds a BA/BS in health-related field, RN licensure, and case management certification within 3 years.