Telephonic Nurse Case Manager
2 weeks ago
We are seeking a skilled Telephonic Nurse Case Manager to join our team at Elevance Health. As a Telephonic Nurse Case Manager, 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.
- Ensure member access to services appropriate to their health needs.
- Conduct 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-contractural 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.
- Assist with development of utilization/care management policies and procedures.
- Requires a BA/BS in a health-related field.
- 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
- Current, unrestricted RN license from the State of Georgia required.
- Multistate licensure is required if this individual is providing services in multiple states.
- Ability to talk and type at the same time preferred.
- Certification as a Case Manager is preferred.
- 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.
We offer a range of market-competitive total rewards, including merit increases, paid holidays, Paid Time Off, and incentive bonus programs. Elevance Health operates 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.
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.
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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