Nurse Case Manager
2 days ago
Job Summary:
Elevance Health is seeking a skilled Nurse Case Manager I to join our team. As a key member of our healthcare team, you will be responsible for providing high-quality care management services 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 effectiveness of care management plans and modify as necessary.
- Interface with Medical Directors and Physician Advisors on the development of care management treatment plans.
- Assist 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 in applicable state(s) required.
- Multi-state licensure is required if this individual is providing services in multiple states.
Preferred Skills:
- Certification as a Case Manager is preferred.
- Oncology or home care experience 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.
Work Environment:
Elevance Health operates in a Hybrid Workforce Strategy. Associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
Equal Employment Opportunity:
Elevance Health is 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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