Nurse Case Manager I
4 weeks ago
Job Summary:
The Nurse Case Manager I is a critical role within Elevance Health, responsible for delivering high-quality care management services to members with complex and chronic care needs. This position requires a skilled and compassionate RN to assess, develop, implement, coordinate, monitor, and evaluate care plans that optimize member healthcare across the care continuum.
Key Responsibilities:
- Conduct thorough assessments to identify individual member needs and develop tailored care management plans.
- 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 member 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.
- Assist in problem-solving with providers, claims, or service issues.
Requirements:
- 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.
About Elevance Health:
Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. 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.
Why Join Us:
At Elevance Health, we offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long-term disability benefits, 401(k) + match, stock purchase plan, life insurance, wellness programs, and financial education resources, to name a few. We operate in a Hybrid Workforce Strategy, and specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
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