Transplant Case Manager II Position

1 month ago


Grand Prairie, Texas, United States Elevance Health Full time
Job Description

Transplant Case Manager II

Elevance Health is seeking a highly skilled 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.

Key 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 the effectiveness of the care management plan 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.
  • Collaborate with healthcare providers and members to promote quality member outcomes, optimize member benefits, and promote effective use of resources for complex medical transplant issues.

Requirements:

  • AS in nursing and minimum of 3 years of clinical experience.
  • Current unrestricted RN license in applicable state(s) required.
  • Ability to interpret and apply member contracts, member benefits, and managed care products.
  • Previous transplant experience is highly desirable.
  • Previous ICU, Med/Surg, and ER experience is extremely helpful for this position.

What We Offer:

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

About Us:

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.



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