RN Transplant Case Manager II

1 week ago


Grand Prairie, Texas, United States Elevance Health Full time
Job Title: RN Transplant Case Manager II

Job Summary:

Elevance Health is seeking a highly skilled RN Transplant Case Manager II to join our team. As a key member of our healthcare team, you will be responsible for providing case management and medical management services to members receiving transplant services.

Responsibilities:

  • Conduct assessments to identify individual needs and develop a specific care management plan to address objectives and goals.
  • 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 needs.
  • Monitor and evaluate effectiveness of the care management plan and modify as needed.
  • 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.
  • Collaborate with healthcare providers and members to promote quality member outcomes, optimize member benefits, and promote effective use of resources for more complex medical transplant issues.

Requirements:

  • Requires AS in nursing 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.

Preferred Qualifications:

  • Previous transplant experience is very strongly preferred.
  • Previous ICU, Med/Surg, and ER experience is extremely helpful for this position.
  • Both Case Management and/or Medical Management (UM/UR) is highly desired.

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:

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.

Work Environment:

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are 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.

Equal Employment Opportunity:

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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