Telephonic Nurse Case Manager II

Elevance Health; Indiana (PA); On-site; USD 75,000 - 95,000; Full time

Benefits offered by this job

Merit increases

Paid holidays

Paid Time Off

Incentive programs

Medical coverage

Dental coverage

Vision benefits

Disability benefits

401(k) + match

Stock purchase plan

Life insurance

Wellness programs

Financial education resources

Job summary

Elevance Health in Indianapolis seeks a Telephonic Nurse Case Manager II to assess, develop, implement and monitor care plans for members with complex and chronic conditions.

In this role you will coordinate referrals, authorizations, and internal/external resources, liaising with Medical Directors to optimize treatment plans.

The position requires a BA/BS in a health field and a current RN license; at least five years of clinical experience, including telephonic case management.

Qualifications

• BA/BS in a health-related field is required.
• Current, unrestricted RN license in applicable state(s) required.
• Multistate licensure required if providing services in multiple states.
• Case Manager certification preferred.

Responsibilities

• Assess individual needs and develop specific care management plans.
• Implement care plans by facilitating authorizations/referrals as appropriate.
• Coordinate internal and external resources to meet identified needs.
• Monitor and evaluate the effectiveness of care management plans and modify as necessary.
• Interface with Medical Directors and Physician Advisors on care management treatment plans.
• Assist in problem solving with providers.
• Assist with the development of utilization/care management policies and procedures.

Skills

Clinical experience

Telephonic case management

Care coordination

Problem solving

Interdisciplinary collaboration

Education

BA/BS in health-related field

RN license

Multi-state licensure

Case Manager Certification

Job description

About This Role

The Telephonic Nurse Case Manager II is responsible for care management for members with complex and chronic care needs, focusing on assessing, developing, implementing, coordinating, monitoring, and evaluating care plans to optimize member health care.

Highlights

• Location: Indianapolis, IN


• Schedule: Full-time, Monday - Friday 9:00am to 5:30pm EST and 1 late evening 11:30am to 8:00pm EST

What You'll Do

• Assess individual needs and develop specific care management plans.


• Implement care plans by facilitating authorizations/referrals as appropriate.


• Coordinate internal and external resources to meet identified needs.


• Monitor and evaluate the effectiveness of care management plans and modify as necessary.


• Interface with Medical Directors and Physician Advisors on care management treatment plans.


• Assist in problem solving with providers.


• Assist with the development of utilization/care management policies and procedures.

Requirements

Education:

• BA/BS in a health-related field required

Experience:

• Minimum of 5 years of clinical experience required


• 2 years’ experience in acute care setting preferred


• 2 years’ telephonic Case Management experience with a Managed Care Company preferred

Licenses & Certifications:

• Current, unrestricted RN license in applicable state(s) required


• Multi-state licensure required if providing services in multiple states


• Certification as a Case Manager preferred

Benefits

• Merit increases


• Paid holidays


• Paid Time Off


• Incentive bonus programs


• Medical, dental, vision benefits


• Short and long-term disability benefits


• 401(k) + match


• Stock purchase plan


• Life insurance


• Wellness programs


• Financial education resources

About Elevance Health

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. They are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels who are passionate about making an impact on their members and communities.