Nurse Care Manager II

2 days ago


Grand Prairie, Texas, United States Elevance Health Full time
Job Summary

We are seeking a skilled Nurse Case Manager II to join our team at Elevance Health. As a key member of our healthcare team, you will play a critical role in collaborating with healthcare providers and consumers to drive personalized health management and improve health outcomes.

Key Responsibilities
  • Collaborate with healthcare providers and consumers to develop and implement personalized care plans that address individual needs and promote optimal health outcomes.
  • Conduct clinical assessments to identify and address complex and chronic care needs, and develop strategies to improve health outcomes.
  • Partner with physician clinical reviewers and medical directors to interpret appropriateness of care, intervention planning, and general clinical guidance.
  • Collaborate with providers to assess consumer needs for early identification of and proactive planning for discharge.
  • Develop and implement care plans that address individual needs, and monitor and evaluate effectiveness of the care management plan and modify as necessary.
  • Assist with development of utilization/care management policies and procedures.
  • Participate in or lead intradepartmental teams, projects, and initiatives.
Requirements
  • A minimum of 3 years of acute care clinical experience, condition-specific clinical experience, home health/discharge planning experience, and a minimum of 1 year in a Nurse Care Mgr I role or equivalent experience.
  • Current, valid active unrestricted RN license in applicable state(s) required. Multi-state licensure is required if this individual is providing services in multiple states.
  • AS or BS in nursing preferred.
  • Certification as a Case Manager is preferred. Participation in the American Association of Managed Care Nurses preferred.
  • Prior managed care experience preferred.
  • Knowledge of medical management process and ability to interpret and apply member contracts, member benefits, and managed care products strongly preferred.
What We Offer

We offer a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401(k) contribution. The salary range for this position is $35.50-$44.37, and the location is Maryland. We are an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status, or any other status or condition protected by applicable federal, state, or local laws.



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