Virtual Nurse Case Manager I - Care Coordination

IntelliResume; Indiana (PA); On-site; USD 65,000 - 85,000; Full time

Benefits offered by this job

Merit increases

Paid holidays

PTO

Incentive bonuses

Medical benefits

Dental benefits

Vision benefits

Disability benefits

401(k) matching

Stock purchase plan

Life insurance

Wellness programs

Financial education

Job summary

Elevance Health in Indianapolis, IN, seeks a Nurse Case Manager I to perform care management for members with complex health needs in a flexible, virtual setting. The role emphasizes effective care coordination across the continuum and collaboration with medical directors and physicians.

The position requires a BA/BS in a health-related field, at least 3 years of clinical experience, and an unrestricted RN license (multi-state licensure may be needed). A Case Manager certification is preferred.

Qualifications

• BA/BS in health-related field required.
• Minimum of 3 years of clinical experience required.
• Current, unrestricted RN license in applicable state(s) required; multi-state licensure if providing services in multiple states; Case Manager certification preferred.

Responsibilities

• Ensure member access to services appropriate to health needs.
• Conduct assessments to identify needs and develop care management plans.
• Implement care plans by facilitating authorizations/referrals as appropriate.
• Coordinate internal and external resources to meet identified needs.
• Monitor and evaluate effectiveness of care plans and modify as needed.
• Interface with Medical Directors and Physician Advisors on care plans.
• Negotiate reimbursement rates, where applicable.
• Assist in problem solving with providers, claims, or service issues.

Education

BA/BS in health-related field

Job description

Elevance Health in Indianapolis, IN, seeks a Nurse Case Manager I to perform care management for members with complex health needs in a flexible, virtual setting. The role emphasizes effective care coordination across the continuum and collaboration with medical directors and physicians.

The position requires a BA/BS in a health-related field, at least 3 years of clinical experience, and an unrestricted RN license (multi-state licensure may be needed). A Case Manager certification is preferred.