Virtual Nurse Case Manager II — Complex Care Coordination

IntelliResume; Indiana (PA); On-site; USD 79,000 - 119,000; Full time

Benefits offered by this job

Benefits package

Incentive programs

Stock purchase & 401k

Job summary

Elevance Health is seeking a Nurse Case Manager II for Indianapolis, IN, to manage care for complex and chronic cases in a virtual setting. The role emphasizes assessing, developing, coordinating, and evaluating care plans while collaborating with medical directors and providers.

The successful candidate will have a BA/BS in a health-related field, a current RN license, and at least five years of clinical experience.

Qualifications

• BA/BS in a health-related field is required.
• Minimum of 5 years of clinical experience.
• 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.

Responsibilities

• Ensure member access to services appropriate to their health needs.
• Conduct assessments to identify individual 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 the effectiveness of care management plans and modify as necessary.
• Interface with Medical Directors and Physician Advisors on care management treatment plans.
• Negotiate rates of reimbursement, as applicable.
• Assist in problem-solving with providers, claims, or service issues.
• Assist with the development of utilization/care management policies and procedures.

Skills

Care management

Assessment

Coordination

Communication with providers

Education

BA/BS in health-related field

Job description

Elevance Health is seeking a Nurse Case Manager II for Indianapolis, IN, to manage care for complex and chronic cases in a virtual setting. The role emphasizes assessing, developing, coordinating, and evaluating care plans while collaborating with medical directors and providers.

The successful candidate will have a BA/BS in a health-related field, a current RN license, and at least five years of clinical experience.