Nurse Care Manager I

2 weeks ago


Columbus, Ohio, United States Elevance Health Full time
Job Summary

The Nurse Care Manager I is a critical role within our organization, responsible for collaborating with healthcare providers and consumers to drive personalized health management and improve health outcomes. This position requires a strong clinical background and excellent communication skills to ensure high-quality, cost-effective care for our members.

Key Responsibilities
  • Assess the medical necessity of inpatient admissions and extensions of stay, outpatient services, and out-of-network services to ensure medically appropriate 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.
  • Conduct clinical assessments to develop goals that address individual needs and develop and implement care plans.
  • Monitor and evaluate the effectiveness of care management plans and modify as necessary.
Requirements
  • A minimum of 3 years of acute care clinical experience or any combination of education and experience that provides an equivalent background.
  • Current, active, valid unrestricted RN license in applicable state(s) required.
  • Multi-state licensure is required if providing services in multiple states.
  • Home health/discharge planning experience preferred.
  • AS or BS in nursing preferred.
  • Certification as a Case Manager is 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.

The salary range for this position is $30.74 - $38.42 per hour, based on a number of legitimate, non-discriminatory factors set by the Company. The actual compensation will vary depending on geographic location, work experience, education, and/or skill level.

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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