Nurse Case Manager II

2 weeks ago

Cary, North Carolina, United States Elevance Health Full time
Job Title: Nurse Case Manager II

Job Summary:

We are seeking a highly skilled Nurse Case Manager II to join our team at Elevance Health. As a key member of our healthcare team, you will be responsible for providing comprehensive care management services to our members with complex and chronic care needs.

Key Responsibilities:

  • Assess, develop, implement, 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 and referrals as appropriate within benefits structures 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 as necessary.
  • 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.
  • Assist with the development of utilization/care management policies and procedures.

Requirements:

  • BA/BS in a health-related field and a minimum of 5 years of clinical experience, or any combination of education and experience that would provide an equivalent background.
  • Current, unrestricted RN license in applicable state(s) required.
  • Multi-state licensure is required if providing services in multiple states.

Preferred Skills:

  • Certification as a Case Manager is preferred.
  • Telephonic Case Management experience is preferred.

About Elevance Health:

Elevance Health is a health company dedicated to improving lives and communities. 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.

Our Culture:

We are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture, and we offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs.

Work Environment:

Elevance Health operates in a Hybrid Workforce Strategy. 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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