RN Case Manager
2 days ago
Job Summary:
Elevance Health is seeking a highly skilled RN Nurse Case Manager I to join our team. As a RN Nurse Case Manager I, you will be responsible for performing care management within the scope of licensure for members with complex and chronic care.
Key Responsibilities:
- Ensures member access to services appropriate to their health needs.
- Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.
- Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements.
- Coordinates internal and external resources to meet identified needs.
- Monitors and evaluates effectiveness of the care management plan and modifies as necessary.
- Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans.
- Negotiates rates of reimbursement, as applicable.
- Assists in problem solving with providers, claims or service issues.
Requirements:
- Requires BA/BS in a health related field and minimum of 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
- Current, unrestricted RN license from the state of Maryland is required.
About Elevance Health:
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
What We Offer:
- Market-competitive total rewards, including merit increases, paid holidays, Paid Time Off, and incentive bonus programs.
- Medical, dental, vision, short and long term disability benefits, 401(k) match, stock purchase plan, life insurance, wellness programs and financial education resources.
How to Apply:
Please submit your application through our website. We are an Equal Employment Opportunity employer and welcome applications from diverse candidates.
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