RN Case Manager I – Care Coordination & Plans

IntelliResume; Missouri; On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Merit increases

Paid holidays

Paid Time Off

Incentive bonus programs

Medical, dental, and vision benefits

Short and long-term disability

401(k) + match

Stock purchase plan

Life insurance

Wellness programs

Financial education resources

Job summary

Elevance Health is seeking a Nurse Case Manager I in St. Louis, MO. The role focuses on care management for members with complex needs, requiring a BA/BS in a health-related field and an RN license.

The position involves coordinating assessments, care plans, and referrals while collaborating with medical directors. Ideal candidates will have at least 3 years of clinical experience, may hold a Case Manager certification, and understand multi-state licensure requirements.

Qualifications

• Bachelor's degree in a health-related field.
• Minimum of 3 years of clinical experience.
• Current, unrestricted RN license in applicable state(s) required
• Multi-state licensure required if providing services in multiple states
• Certification as a Case Manager preferred
• BS in a health or human services related field preferred

Responsibilities

• Ensure member access to services appropriate to their health needs.
• Conduct assessments to identify individual needs and develop care management plans.
• Implement care plans by facilitating authorizations/referrals as appropriate.
• Coordinate internal and external resources to meet identified needs.
• Monitor and evaluate the effectiveness of care management plans and modify as necessary.
• Interface with Medical Directors and Physician Advisors on care management treatment plans.
• Negotiate rates of reimbursement, as applicable.
• Assist in problem solving with providers, claims, or service issues.

Job description

Elevance Health is seeking a Nurse Case Manager I in St. Louis, MO. The role focuses on care management for members with complex needs, requiring a BA/BS in a health-related field and an RN license.

The position involves coordinating assessments, care plans, and referrals while collaborating with medical directors. Ideal candidates will have at least 3 years of clinical experience, may hold a Case Manager certification, and understand multi-state licensure requirements.