Senior Nurse Case Manager II - Complex Care & Coordination

Elevance Health; Colorado; On-site; USD 79,000 - 125,000; Full time

Benefits offered by this job

Comprehensive benefits package

Equity stock purchase

401k contribution

Job summary

Elevance Health is seeking a Nurse Case Manager II in Denver, CO. The role focuses on assessing, developing, implementing, coordinating, monitoring, and evaluating care plans for members with complex and chronic needs to optimize health outcomes.

Responsibilities include collaborating with Medical Directors, facilitating authorizations/referrals, coordinating resources, and contributing to policy development. The position offers full-time scheduling and a strong benefits package.

Qualifications

• BA/BS in health-related field required.
• Minimum of 5 years of clinical experience required.
• Current, unrestricted RN license in applicable state(s) required; multi-state licensure should be in place if serving multiple states.
• Certification as a Case Manager preferred.

Responsibilities

• Assess individual member needs and develop care management plans.
• Implement care plans by facilitating authorizations/referrals.
• Coordinate internal and external resources to meet identified needs.
• Monitor and evaluate the 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, claims, or service issues.
• Contribute to the development of utilization/care management policies and procedures.

Skills

Care coordination

Clinical assessment

Interdisciplinary collaboration

Communication

Education

BA/BS in health-related field

Job description

Elevance Health is seeking a Nurse Case Manager II in Denver, CO. The role focuses on assessing, developing, implementing, coordinating, monitoring, and evaluating care plans for members with complex and chronic needs to optimize health outcomes.

Responsibilities include collaborating with Medical Directors, facilitating authorizations/referrals, coordinating resources, and contributing to policy development. The position offers full-time scheduling and a strong benefits package.