Clinical Health Manager

3 weeks ago


Waukesha, Wisconsin, United States Elevance Health Full time
Job Summary:\
We are seeking a skilled Nurse Care Manager I to join our team at Elevance Health. This role will involve collaborating with healthcare providers and consumers to drive personalized health management and improve health outcomes.\
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Responsibilities:\
* Collaborate with healthcare providers and/or consumers to develop and implement care plans that address individual needs.\
* Conduct clinical assessments to identify areas for improvement and develop goals to address these needs.\
* Partner with physician clinical reviewers and/or medical directors to interpret appropriateness of care and provide general clinical guidance.\
* Ensure medically appropriate, high-quality, cost-effective care through assessing the medical necessity of inpatient admissions and extensions of stay, outpatient services, out-of-network services, and appropriateness of treatment setting and level of care.\
* Monitor and evaluate the effectiveness of care management plans and modify as necessary.\
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Requirements:\
* A minimum of 3 years of acute care clinical experience or any combination of education and experience that provides an equivalent background.\
* Current, active valid unrestricted RN license in applicable state(s) required.\
* Multi-state licensure is required if this individual is providing services in multiple states.\
* Home health/discharge planning experience preferred.\
\
Compensation:\
The salary range for this position is $30.74 - $38.42 per hour. Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401(k) contribution.

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