Nurse Case Manager I

3 weeks ago

Houston, Texas, United States Elevance Health Full time
Job Summary

The Telephonic Nurse Case Manager I is a vital role at Elevance Health, responsible for delivering high-quality care management services to members with complex and chronic care needs. This position requires a skilled and compassionate nurse to assess, develop, implement, and evaluate care plans that optimize member health care across the care continuum.

Key Responsibilities

- 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, ensuring seamless care transitions and optimal outcomes.
- Monitor and evaluate the effectiveness of care management plans, modifying them as necessary to ensure continuous improvement.
- Interface with Medical Directors and Physician Advisors on the development of care management treatment plans, ensuring alignment with member needs and goals.

Requirements

- Bachelor's degree 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 the applicable state(s) is required, with multi-state licensure necessary for providing services in multiple states.

Preferred Qualifications

- Certification as a Case Manager is preferred, with a minimum of 2 years of hospital experience also highly valued.
- Excellent multi-tasking, attention to detail, critical thinking, and customer service skills, with the ability to learn quickly and adapt to changing situations.
- Experience in ER, ICU, Home Health, Hospice, and Oncology settings is a plus, with a strong understanding of the healthcare system and its complexities.

About Elevance Health

Elevance Health is a health company dedicated to improving lives and communities, with a longstanding history in the healthcare industry. We are committed to creating a culture that advances our strategy, leads to personal and professional growth for our associates, and drives shared success for our consumers, associates, communities, and business.

What We Offer

- Market-competitive total rewards, including merit increases, paid holidays, Paid Time Off, and incentive bonus programs.
- Comprehensive benefits package, including medical, dental, vision, short and long-term disability benefits, 401(k) + match, stock purchase plan, life insurance, wellness programs, and financial education resources.
- Hybrid Workforce Strategy, with the option to work from home or in an Elevance Health location, with specific requirements and expectations discussed during the hiring process.

Equal Employment Opportunity

Elevance Health is an Equal Employment Opportunity employer, 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. We welcome applications from diverse candidates and are an inclusive employer, dedicated to creating a workplace that values and respects all individuals.

How to Apply

Apply now to join our team of dedicated healthcare professionals and make a meaningful difference in the lives of our members. Please note that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

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