Clinical Care Manager

2 weeks ago


Sens, Bourgogne-Franche-Comté, United States Elevance Health Full time
Job Description

This role involves working as a Clinical Care Manager for Elevance Health, a Fortune 25 company dedicated to improving lives and communities.

About the Job

We are seeking a skilled RN Nurse Case Manager I to join our team. As a Clinical Care Manager, you will be responsible for performing care management within the scope of licensure for members with complex and chronic care needs.

You will assess, develop, implement, coordinate, monitor, and evaluate care plans designed to optimize member healthcare across the care continuum. This may involve duties such as discharge planning at hospitals or conducting assessments to identify individual needs and developing specific care management plans.

Key Responsibilities
  • Ensures member access to services appropriate to their health needs
  • Conducts assessments to identify individual needs and develops 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
  • Covers 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
Requirements

To qualify for this role, you must have:

  • Bachelor's degree in a health-related field
  • Minimum of 3 years of clinical experience
  • Current, unrestricted RN license in applicable state(s)
  • Multi-state licensure required if providing services in multiple states
Benefits

Elevance Health offers a comprehensive benefits package, including merit increases, paid holidays, Paid Time Off, and incentive bonus programs. Additionally, we offer medical, dental, vision, short- and long-term disability benefits, 401(k) + match, stock purchase plan, life insurance, wellness programs, and financial education resources.

Estimated Salary Range

The estimated salary range for this role is $67,116 to $110,262 based on market conditions and location.

Company Overview

Elevance Health operates in a Hybrid Workforce Strategy, requiring associates to work at an Elevance Health location at least once per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health, and we require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19.



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