RN Virtual Case Manager I — Care Coordination

Elevance Health; New York (NY); Remote; USD 71,000 - 106,000; Full time

Benefits offered by this job

Comprehensive benefits package

Incentive and recognition programs

401(k) contribution

Equity stock purchase plan

Job summary

Elevance Health is seeking a Nurse Case Manager I to perform care management for members with complex and chronic needs. This role supports coordination in a virtual work environment and involves developing and evaluating care plans.

Shifts include some evenings; location is Latham, NY, with full-time hours and a comprehensive benefits package. Minimum 3 years clinical experience and an active RN license are required, with multi-state licensure as needed.

Qualifications

• BA/BS in a health-related field is required.
• Minimum of 3 years of clinical experience.
• RN license active/unrestricted; multi-state licensure if serving multiple states.
• Case Manager certification preferred.

Responsibilities

• Assess and develop care management plans for members.
• Implement care plans via authorizations and referrals.
• Coordinate internal and external resources to meet identified needs.
• Monitor and evaluate effectiveness of care management plans.
• Interface with Medical Directors and Physician Advisors on treatment plans.
• Negotiate rates of reimbursement as applicable.
• Assist in problem-solving with providers and claims issues.

Skills

Care coordination

Clinical experience

Communication

Education

BA/BS in health-related field

Job description

Elevance Health is seeking a Nurse Case Manager I to perform care management for members with complex and chronic needs. This role supports coordination in a virtual work environment and involves developing and evaluating care plans.

Shifts include some evenings; location is Latham, NY, with full-time hours and a comprehensive benefits package. Minimum 3 years clinical experience and an active RN license are required, with multi-state licensure as needed.