RN Case Manager II — Expert Care Coordinator

IntelliResume; New York (NY); On-site; USD 79,000 - 119,000; Full time

Benefits offered by this job

Comprehensive benefits package

Incentive and recognition programs

Equity stock purchase

401k contribution

Job summary

Elevance Health in New York is seeking a Nurse Case Manager II to perform care management for members with complex and chronic needs, assessing, developing, coordinating, monitoring and evaluating care plans to optimize health outcomes.

Based in Latham, NY, this full-time role offers a competitive salary with comprehensive benefits and collaboration with Medical Directors and providers to improve utilization and care policies.

Qualifications

• BA/BS in health-related field is required.
• Active, unrestricted RN license in applicable state(s) required; multi-state licensure preferred.
• Certification as a Case Manager is a plus.

Responsibilities

• Ensure member access to services appropriate to health needs.
• Conduct assessments to identify needs and develop care plans.
• Implement care plans via authorizations/referrals as needed.
• Coordinate internal and external resources to meet needs.
• Monitor and evaluate care management plan effectiveness and adjust as needed.
• Interface with Medical Directors and Physician Advisors on care plans.
• Negotiate rates of reimbursement as applicable.
• Assist with problem-solving with providers, claims, or service issues.
• Help develop utilization/care management policies and procedures.

Skills

Care management

Assessment & care planning

Interpersonal communication

Education

BA/BS in health-related field

Current, unrestricted RN license in applicable state(s)

Multistate licensure

Certification as a Case Manager (preferred)

Job description

Elevance Health in New York is seeking a Nurse Case Manager II to perform care management for members with complex and chronic needs, assessing, developing, coordinating, monitoring and evaluating care plans to optimize health outcomes.

Based in Latham, NY, this full-time role offers a competitive salary with comprehensive benefits and collaboration with Medical Directors and providers to improve utilization and care policies.