Telephonic Nurse Case Manager II — Impactful Care Leader

IntelliResume; Denver (CO); On-site; USD 79,000 - 131,000; Full time

Benefits offered by this job

Comprehensive benefits package

Incentive and recognition programs

Equity stock purchase and 401k

Job summary

Elevance Health is seeking a Telephonic Nurse Case Manager II in Denver, CO to lead care management for members with complex and chronic needs. You will assess, plan, implement, coordinate, monitor, and evaluate care to optimize health outcomes.

Requirements include a BA/BS in a health-related field, at least 5 years of clinical experience (acute care preferred), and an unrestricted RN license with multi-state licensure. The role offers a comprehensive benefits package and a $2000 sign-on bonus.

Qualifications

• BA/BS in a health-related field required.
• Minimum 5 years of clinical experience required.
• Multi-state licensure required for services in multiple states; RN license active.

Responsibilities

• Ensure member access to services appropriate to health needs.
• Conduct assessments to identify needs and develop care management plans.
• Implement care plans via authorizations/referrals as appropriate.
• Coordinate internal and external resources to meet needs.
• Monitor and evaluate care plans; modify as necessary.
• Interface with Medical Directors and Physician Advisors on plans.
• Negotiate rates of reimbursement, as applicable.
• Assist with problem-solving with providers, claims, or service issues.
• Assist with development of utilization/care management policies.

Skills

Care coordination

Assessments

Communication with providers

Utilization management

Education

BA/BS in health field

Tools

Case management software

Job description

Elevance Health is seeking a Telephonic Nurse Case Manager II in Denver, CO to lead care management for members with complex and chronic needs. You will assess, plan, implement, coordinate, monitor, and evaluate care to optimize health outcomes.

Requirements include a BA/BS in a health-related field, at least 5 years of clinical experience (acute care preferred), and an unrestricted RN license with multi-state licensure. The role offers a comprehensive benefits package and a $2000 sign-on bonus.