Virtual RN Case Manager II – Multistate Licensure

Elevance Health; Colorado; Hybrid; USD 85,000 - 110,000; Full time

Job summary

Elevance Health is seeking a Nurse Case Mgr II (RN) to oversee care management for members with complex and chronic needs. This virtual, full-time role requires multi-state RN licensure and occasional in-person training. Alternate locations may be considered within commuting distance.

The Nurse Case Mgr II will conduct assessments, plan and coordinate care, monitor outcomes, and collaborate with Medical Directors and health professionals to optimize access to appropriate services.

Qualifications

• Requires BA/BS in a health related field and minimum of 5 years of clinical experience; Current, unrestricted RN license in applicable state(s) is required.
• Multi-state RN licensure is required for providing services in multiple states upon hire.
• Active California RN license is highly preferred.

Responsibilities

• Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.
• Assists in facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements.
• Monitors and evaluates effectiveness of the care management plan and modifies as necessary.
• Interfaces with Medical Directors and other health professionals on the development of care management treatment plans.
• Assists in problem solving with providers, claims or service issues.
• Assists with development of utilization/care management policies and procedures.

Skills

Case management

Managed care

Telephonic/virtual nursing

Education

BA/BS in health related field

RN license in applicable state(s)

Active California RN license preferred

Tools

Microsoft Office suite

Job description

Elevance Health is seeking a Nurse Case Mgr II (RN) to oversee care management for members with complex and chronic needs. This virtual, full-time role requires multi-state RN licensure and occasional in-person training. Alternate locations may be considered within commuting distance.

The Nurse Case Mgr II will conduct assessments, plan and coordinate care, monitor outcomes, and collaborate with Medical Directors and health professionals to optimize access to appropriate services.