Telephonic Nurse Case Manager I

Elevance Health; Atlanta (GA); Remote; USD 60,000 - 90,000; Full time

Job summary

An innovative health organization is seeking a dedicated Telephonic Nurse Case Manager I to manage complex care for members. This role involves assessing needs, developing care plans, and collaborating with medical professionals to optimize health outcomes. With a focus on remote work, this position offers flexibility and the chance to make a significant impact on patient care. Ideal candidates will possess strong clinical skills, critical thinking abilities, and a passion for improving health services. Join a forward-thinking team committed to delivering exceptional care and enhancing the lives of individuals across multiple states.

Qualifications

• 3+ years of clinical experience or equivalent education and experience.
• Current RN license in Georgia and Multi-State Licensure if needed.

Responsibilities

• Manage telephonic care for members with complex needs.
• Conduct assessments and develop care management plans.
• Monitor and evaluate care plan effectiveness.

Skills

Clinical Assessment

Care Coordination

Critical Thinking

Microsoft Office Proficiency

Communication Skills

Education

BA/BS in Health-related Field

Job description

Telephonic Nurse Case Manager I

Location: Virtual: This role enables associates to work remotely full-time, with required in-person training sessions. This setup offers flexibility, promotes productivity, and supports work-life balance.

Must reside in Georgia.

Work schedule: Monday - Friday, 11:00 am - 7:30 pm, with one weekly shift from 8:30 am to 5:00 pm EST.

Note: This position services members across different states; therefore, Multi-State Licensure is required.

Pre-employment Skills Assessment: This position requires an online skills assessment, which is free and accessible from any PC with internet. Candidates meeting minimum requirements will be contacted via email with instructions. Completion within 48 hours is necessary to proceed.

Position Overview

The Telephonic Nurse Case Manager I manages telephonic care for members with complex and chronic needs, assessing, developing, implementing, coordinating, monitoring, and evaluating care plans to optimize health outcomes across the continuum.

How You Will Make an Impact

• Ensure member access to appropriate services.
• Conduct assessments to identify needs and develop care management plans.
• Facilitate authorizations and referrals within benefits or through external arrangements.
• Coordinate resources to meet needs.
• Monitor and evaluate care plan effectiveness, making adjustments as needed.
• Collaborate with Medical Directors and Physician Advisors on treatment plans.
• Assist with problem-solving related to providers, claims, or services.
• Contribute to developing utilization and care management policies.

Minimum Requirements

• BA/BS in a health-related field.
• At least 3 years of clinical experience, or equivalent education and experience.
• Current, unrestricted RN license in Georgia.
• Multi-State Licensure if providing services in multiple states.

Preferred Skills and Experiences

• Ability to talk and type simultaneously.
• Case Management certification.
• Critical thinking skills.
• Proficiency with Microsoft Office or quick learner of new systems.
• Timely response to emails and messages.

Note: Elevance Health only accepts resumes from agencies with a signed agreement. Unsolicited resumes are the property of Elevance Health.