Nurse Case Manager Senior

3 weeks ago


Atlanta, Georgia, United States Elevance Health Full time
Job Summary

We are seeking a highly skilled Nurse Case Manager to join our team at Elevance Health. As a key member of our healthcare team, you will be responsible for 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
  • Assess the medical necessity of inpatient admissions, outpatient services, and out-of-network services
  • Partner with physician clinical reviewers and medical directors to interpret appropriateness of care and intervention planning
  • Implement and coordinate care plans, monitoring and evaluating their effectiveness and making necessary modifications
  • Function as a preceptor for new care management staff and assist with the development of care management policies and procedures
  • Participate in intradepartmental and cross-functional teams, projects, and initiatives, as well as process improvement activities
Requirements
  • A minimum of 5 years of acute care clinical experience, condition-specific clinical experience, home health/discharge planning experience, case management experience, disease management experience, and a minimum of 1 year in a Nurse Care Manager II role or equivalent experience
  • A HS diploma or equivalent and a BS in nursing is preferred
What We Offer

Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401(k) contribution. We are committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.



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