Nurse Care Manager II

4 weeks ago


Walnut Creek, California, United States Elevance Health Full time
Care Management Role at Elevance Health

We are seeking a skilled Care Manager to join our team at Elevance Health. As a Care Manager, 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 care plans that address individual needs.
  • 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.
  • Conduct clinical assessments to develop goals that address individual needs and implement and coordinate care plans.
  • Monitor and evaluate the effectiveness of care management plans and modify as necessary.

Requirements:

  • Current, valid active unrestricted RN license in the state of California.
  • Minimum of 3 years of acute care clinical experience, condition-specific clinical experience, home health/discharge planning experience.
  • Minimum of 1 year in a Nurse Care Manager I role or equivalent experience.

Preferred Qualifications:

  • AS or BS in nursing.
  • Certification as a Case Manager.
  • Participation in the American Association of Managed Care Nurses.

About Elevance Health:

Elevance Health is a health company dedicated to improving lives and communities. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.


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