Nurse Case Manager II Position
10 hours ago
Job Summary:
Elevance Health is seeking a skilled Nurse Case Manager II to join our team. As a Telephonic Nurse Case Manager II, you will be responsible for providing care management services to members with complex and chronic care needs.
Key Responsibilities:
- Assess, develop, implement, coordinate, monitor, and evaluate care plans to optimize member health care across the care continuum.
- Conduct 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 benefits structure or through extra-contractual arrangements.
- Coordinate internal and external resources to meet identified needs.
- Monitor and evaluate effectiveness of care management plans and modify as necessary.
- Interface with Medical Directors and Physician Advisors on the development of care management treatment plans.
- Negotiate rates of reimbursement, as applicable.
- Assist in problem solving with providers, claims or service issues.
- Assist with development of utilization/care management policies and procedures.
Requirements:
- BA/BS in a health-related field and minimum of 5 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
- Current, unrestricted RN license in applicable state required.
- Multi-state licensure is required if this individual is providing services in multiple states.
Preferred Capabilities, Skills and Experiences:
- Certification as a Case Manager is preferred.
- Compact RN license preferred.
- Minimum 2 years' experience in acute care setting.
- Managed Care experience.
- Ability to talk and type at the same time.
- Demonstrate critical thinking skills when interacting with members.
- Experience with Microsoft Office and/or ability to learn new computer programs/systems/software quickly.
- Ability to manage, review and respond to emails/instant messages in a timely fashion.
Work Environment:
This is a virtual position. Candidates must reside within 50 miles of an Elevance Health Pulse Point location.
Salary and Benefits:
The salary range for this position is $75,684 to $124,338. Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401(k) contribution.
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