Nurse Case Manager I

4 weeks ago


Latham, New York, United States Elevance Health Full time

Care Management Role

The Nurse Case Manager I is a critical position at Elevance Health, responsible for delivering high-quality care management services to members with complex and chronic care needs. This role involves assessing, developing, implementing, coordinating, monitoring, and evaluating care plans to optimize member healthcare across the care continuum.

Key Responsibilities:

  • Ensures member access to services appropriate to their health needs.
  • Conducts assessments to identify individual needs and develops a specific care management plan to address objectives and goals.
  • Implements care plans by facilitating authorizations/referrals as appropriate within benefits structures or through extra-contractual arrangements.
  • Coordinates internal and external resources to meet identified needs.
  • Monitors and evaluates the effectiveness of care management plans and modifies as necessary.
  • Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans.
  • Assists in problem-solving with providers, claims, or service issues.

Requirements:

  • Requires a BA/BS in a health-related field and a minimum of 3 years of clinical experience; or any combination of education and experience that provides an equivalent background.
  • Current, unrestricted RN license in applicable state(s) required.
  • Multi-state licensure is required if this individual is providing services in multiple states.

Preferred Skills:

  • Certification as a Case Manager is preferred.
  • Oncology or home care experience is preferred.

Additional Information:

Elevance Health is a health company dedicated to improving lives and communities. We offer a range of market-competitive total rewards, including merit increases, paid holidays, Paid Time Off, and incentive bonus programs. We operate in a Hybrid Workforce Strategy, requiring associates to work at an Elevance Health location at least once per week. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.


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