Nurse Case Manager I
7 days ago
We are seeking a skilled Nurse Case Manager I to join our team at Elevance Health. As a key member of our care management team, you will be responsible for providing high-quality care 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.
- Conduct thorough 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 the benefits structure or through extra-contractual arrangements.
- Coordinate internal and external resources to meet identified needs.
- Monitor and evaluate the effectiveness of care management plans and modify them as necessary.
- Interface with Medical Directors and Physician Advisors on the development of care management treatment plans.
- Negotiate rates of reimbursement, as applicable.
- Assist in problem-solving with providers, claims, or service issues and all member needs or concerns.
- Requires BA/BS in a health-related field and a 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 the applicable state(s) is required.
- Multi-state licensure is required if this individual is providing services in multiple states.
- Certification as a Case Manager is preferred.
- A minimum of 2 years hospital experience is preferred.
- Excellent multi-tasking, attention to detail, critical thinking, and customer service skills, and a fast learner.
- Experience in any or all of the following areas is a plus: ER, ICU, Home Health, Hospice, and Oncology.
We offer a range of market-competitive total rewards, including merit increases, paid holidays, Paid Time Off, and incentive bonus programs. Our comprehensive benefits package includes medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs, and financial education resources.
We operate in a Hybrid Workforce Strategy, with associates required to work at an Elevance Health location at least once per week, and potentially several times 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.
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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