Telephonic Nurse Case Manager II

Elevance Health; Atlanta (GA); Remote; USD 76,000 - 121,000; Full time

Job summary

A leading health company seeks a Telephonic Nurse Case Manager II to manage care for members with complex needs. This remote role involves assessments, developing care plans, and collaborating with medical professionals. Candidates must have a health-related degree, RN license, and relevant experience. The position offers a competitive salary and comprehensive benefits.

Benefits

Comprehensive benefits packages

Incentive programs

Stock purchase

401(k)

Qualifications

• 5 years of clinical experience or equivalent education and experience.
• Unrestricted RN license in applicable state(s); multi-state licensure required.

Responsibilities

• Conduct assessments and develop care management plans.
• Collaborate with Medical Directors on treatment plans.
• Ensure member access to appropriate services.

Skills

Critical thinking

Communication

Adaptability

Education

BA/BS in a health-related field

Tools

Microsoft Office

Job description

Join to apply for the Telephonic Nurse Case Manager II role at Elevance Health.

Location: Virtual — This role allows associates to work remotely full-time, with required in-person training sessions, promoting flexibility and productivity.

Hours: Monday - Friday, 9:00am to 5:30pm EST, with one late evening shift from 11:30am to 8:00pm EST.

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

Note: An online pre-employment skills assessment is required. It is free and can be completed from any PC with internet access. Candidates who meet the minimum requirements will be contacted via email with further instructions. The assessment must be completed within 48 hours of receipt to proceed.

The Telephonic Nurse Case Manager II is responsible for care management of members with complex and chronic needs, including assessment, planning, coordination, and evaluation of care plans, performed telephonically.

How You Will Make An Impact

• Ensure member access to appropriate services.
• Conduct assessments and develop care management plans.
• Facilitate authorizations and referrals within benefits or through arrangements.
• Coordinate resources and monitor plan effectiveness.
• Collaborate with Medical Directors and Physician Advisors on treatment plans.
• Negotiate reimbursement rates as applicable.
• Assist with problem-solving related to providers, claims, or services.

Minimum Requirements

• BA/BS in a health-related field and 5 years of clinical experience, or equivalent education and experience.
• Unrestricted RN license in applicable state(s); multi-state licensure required if serving multiple states.

Preferred Skills and Experience

• Case Management certification.
• Ability to talk and type simultaneously.
• Critical thinking skills.
• Proficiency with Microsoft Office and quick adaptability to new systems.
• Experience managing emails and messages promptly.
• At least 2 years of acute care and telephonic case management experience, preferably with managed care.

Salary Range: $76,944 to $120,912, depending on location and experience.

Locations: Colorado; New York.

Benefits include comprehensive packages, incentive programs, stock purchase, 401(k), and more. Elevance Health is committed to equal pay and opportunity.

Note: Specific onsite requirements and vaccination policies are in place, and applicants requiring accommodations should contact support.