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Nurse Case Manager Sr-1
2 months ago
We are seeking a highly skilled and experienced Nurse Case Manager Sr-1 to join our team at Elevance Health. As a key member of our healthcare team, you will be responsible for collaborating with healthcare providers and consumers to drive personalized health management and improve health outcomes for our members.
Key Responsibilities- Assess the medical necessity of inpatient admissions, outpatient services, and out-of-network services to ensure high-quality, cost-effective care.
- Partner with physician clinical reviewers and medical directors to interpret appropriateness of care, intervention planning, and general clinical guidance.
- Collaborate with providers to assess consumer needs for early identification of and proactive planning for discharge.
- Implement and coordinate care plans, monitor and evaluate their effectiveness, and modify as necessary.
- Serve as a resource to lower-level nurses and function as a preceptor for new care management staff.
- Assist with the development of care management policies, procedures, and new programs.
- Participate in or lead intradepartmental and cross-functional teams, projects, and initiatives, as well as process improvement activities.
- A minimum of 5 years of acute care clinical experience, condition-specific clinical experience, home health/discharge planning experience, case management experience, disease management experience, and a minimum of 1 year in a Nurse Care Mgr II role or equivalent experience.
- A current, active, valid unrestricted RN license in the applicable state(s) is required.
- Multi-state licensure is required if providing services in multiple states.
- An AS or BS in nursing is preferred.
- Certification as a Case Manager is preferred.
We offer a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401(k) contribution, among other benefits. The salary range for this position is $38.37 to $47.96, and the salary offered will be based on a number of legitimate, non-discriminatory factors set by the Company.
Elevance Health operates in a Hybrid Workforce Strategy, and associates are required to work at an Elevance Health location at least once per week. 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.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation.
