Remote Telephonic RN Case Manager II

Elevance Health; Miami (FL); Hybrid; USD 85,000 - 105,000; Full time

Benefits offered by this job

Hybrid work model

Job summary

Elevance Health, through AmeriBen, is seeking a Telephonic RN Nurse Case Manager II to manage complex and chronic cases. The role offers virtual, full-time work with required in-person training and occasional on-site discharge planning.

Candidates should have a BA/BS in a health field, 5+ years clinical experience, and an unrestricted RN license, with multi-state licensure as needed. A hybrid work model is supported by policy.

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 providing services in multiple states.

Responsibilities

• Assess, develop, implement and monitor care plans for members with complex or 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 management plan and modify as necessary.
• Interface with Medical Directors and Physician Advisors on care management treatment plans.
• Assist in problem solving with providers and contribute to utilization/care management policies.

Skills

RN license

Multistate licensure

Care management

Utilization review

Critical thinking

Microsoft Office

Education

BA/BS in health field

Tools

EMR systems

Office suite

Job description

Elevance Health, through AmeriBen, is seeking a Telephonic RN Nurse Case Manager II to manage complex and chronic cases. The role offers virtual, full-time work with required in-person training and occasional on-site discharge planning.

Candidates should have a BA/BS in a health field, 5+ years clinical experience, and an unrestricted RN license, with multi-state licensure as needed. A hybrid work model is supported by policy.