Nurse Case Manager I

4 weeks ago

Portland, Maine, United States Elevance Health Full time

Job Summary:

The Nurse Case Manager I is a critical role within 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 RN 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 tailored care management plans.
  • Implement care plans by facilitating authorizations and referrals as necessary, ensuring seamless coordination of internal and external resources.
  • Monitor and evaluate the effectiveness of care management plans, making adjustments as needed to ensure optimal member outcomes.
  • Collaborate with Medical Directors and Physician Advisors to develop care management treatment plans.
  • Assist in problem-solving with providers, claims, or service issues.

Requirements:

  • 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 providing services in multiple states.

Preferred Skills and Experiences:

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

What We Offer:

Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401(k) contribution, among other perks. We are committed to creating a culture that advances our strategy and fosters personal and professional growth for our associates.

How to Apply:

Please submit your application through our website. We are an Equal Employment Opportunity employer and welcome applications from diverse candidates. If you require accommodation to participate in the job application process, please contact us for assistance.

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