Nurse Case Manager II Position

3 weeks ago

Chicago, Illinois, United States Elevance Health Full time
Job Summary

We are seeking a skilled and compassionate Nurse Case Manager II to join our team at Elevance Health. As a Telephonic Nurse Case Manager II, you will play a critical role in delivering high-quality care to our members with complex and chronic care needs.

Key Responsibilities
  • Assess, develop, implement, coordinate, monitor, and evaluate care plans to optimize member health care across the care continuum.
  • Conduct thorough assessments to identify individual needs and develop specific care management plans to address objectives and goals.
  • Implement care plans by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements.
  • Coordinate internal and external resources to meet identified needs.
  • Monitor and evaluate the effectiveness of care management plans and modify as necessary.
  • Interface with Medical Directors and Physician Advisors on the development of care management treatment plans.
  • Negotiate rates of reimbursement, as applicable.
  • Assist in problem-solving with providers, claims, or service issues.
Requirements
  • Requires a BA/BS in a health-related field; 5 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
  • Current, unrestricted RN license in applicable state(s) required.
  • Multi-state licensure is required if this individual is providing services in multiple states.
Preferred Capabilities, Skills, and Experiences
  • Certification as a Case Manager is preferred.
  • Ability to talk and type at the same time.
  • Demonstrate critical thinking skills when interacting with members.
  • Experience with Microsoft Office and/or ability to learn new computer programs/systems/software quickly.
  • Ability to manage, review, and respond to emails/instant messages in a timely fashion.
  • Minimum 2 years' experience in an acute care setting preferred.
  • Minimum 2 years 'telephonic' Case Management experience with a Managed Care Company preferred.
  • Managed Care experience preferred.
What We Offer

Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401(k) contribution. The salary range for this position is $75,684 to $124,338, based on a number of legitimate, non-discriminatory factors set by the Company.

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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