RN Nurse Case Manager ll (California HMO)

Elevance Health; California (MO); On-site; USD 83,000 - 136,000; Full time

Benefits offered by this job

Comprehensive benefits package

Incentive programs

Equity stock purchase

401k contribution

Job summary

Elevance Health is seeking an RN Case Manager II (California HMO) to perform care management for members with complex and chronic care needs. Ideal for experienced nurses who excel at assessing, developing, and coordinating care plans in a managed care setting.

Based in Woodland Hills, CA, this full-time role offers 8-hour shifts between 8am and 6pm PST. Compensation ranges from $83,248 to $136,224 annually, with a comprehensive benefits package and opportunities to collaborate with Medical

Qualifications

• BA/BS in a health-related field required.
• Minimum of 5 years of clinical experience.
• Current, unrestricted RN license in California.
• Certification as a Case Manager preferred.

Responsibilities

• Perform care management within the scope of licensure for members with complex and chronic care needs.
• Conduct assessments to identify individual needs and develop specific 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.
• Assist in problem solving with providers, claims, or service issues.
• Assist with the development of utilization/care management policies and procedures.

Education

BA/BS in a health-related field

Job description

About This Role

The RN Nurse Case Manager ll (California HMO) is responsible for performing care management for members with complex and chronic care needs. This role is ideal for experienced nurses who excel in assessing, developing, and coordinating care plans.

Highlights

• Pay: $83,248 - $136,224/year


• Location: Woodland Hills, CA


• Schedule: Full-time, 8 hour shift within the hours of 8am – 6pm PST

What You'll Do

• Perform care management within the scope of licensure for members with complex and chronic care needs.


• Conduct assessments to identify individual needs and develop specific 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.


• Assist in problem solving with providers, claims, or service issues.


• Assist with the development of utilization/care management policies and procedures.

Requirements

Education:

• BA/BS in a health-related field required

Experience:

• Minimum of 5 years of clinical experience required

Licenses & Certifications:

• Current, unrestricted RN license in the state of California required


• Certification as a Case Manager preferred

Benefits

• Comprehensive benefits package


• Incentive and recognition programs


• Equity stock purchase and 401k contribution

About Elevance Health

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. They are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels who are passionate about making an impact on their members and the communities they serve.