Senior Nurse Case Manager - Remote Care Coordination

Elevance Health; Tampa (FL); Hybrid; USD 84,000 - 126,000; Full time

Benefits offered by this job

Benefits package

Equity stock purchase

401k contribution

Job summary

Elevance Health is hiring a Nurse Case Manager Senior to oversee complex care plans for members with chronic needs. The role emphasizes telephonic care management with some in-person training, requiring licensure and cross-state eligibility.

The position offers a hybrid/work-from-home arrangement with occasional onsite requirements and a salary range reflective of New York postings. A comprehensive benefits package is provided as part of total rewards.

Qualifications

• Requires BA/BS in a health-related field and minimum of 5 years of clinical experience.
• Current, unrestricted RN license in home state required.
• Multi-state licensure is required if this individual is providing services in multiple states.

Responsibilities

• Ensures member access to services appropriate to their health needs.
• Conducts assessments to identify individual needs and develops a care management plan.
• Implements care plan by facilitating authorizations/referrals within benefits structure or through extra-contractual arrangements.
• Coordinates internal and external resources to meet identified needs.
• Monitors and evaluates effectiveness of the care management plan and modifies as necessary.
• Interfaces with Medical Directors and Physician Advisors on plan development.
• Negotiates rates of reimbursement and assists with provider/service issues.
• Chairs and schedules meetings and participates in cross-brand workgroups.
• May develop a focused skill set for specific disease processes and acts as preceptor.

Skills

RN license

Education

BA/BS in health-related field

Job description

Elevance Health is hiring a Nurse Case Manager Senior to oversee complex care plans for members with chronic needs. The role emphasizes telephonic care management with some in-person training, requiring licensure and cross-state eligibility.

The position offers a hybrid/work-from-home arrangement with occasional onsite requirements and a salary range reflective of New York postings. A comprehensive benefits package is provided as part of total rewards.