Elevance Health
Healthcare
NurseCaseManager
“Nurse Case Manager at Elevance Health. Skills: Care management, RN license. Perform care management within scope of licensure. Assess, develop, implement, coordinate, monitor, and evaluate care plans”
Industry & Context.
Assists in problem solving with providers, claims or service issues
Field-based role, Travel to client sites or designated locations, Occasional office attendance for meetings or training, Candidates not within reasonable commuting distance will not be considered, COVID-19 and Influenza vaccination required for certain patient/member-facing roles
What They're Looking For.
Must Have
BAS in a health-related field, minimum of 3 years of clinical or any combination of education and experience, Current, unrestricted RN license in applicable state(s), Multi-state licensure is required if this individual is providing services in multiple states
Nice to Have
Certification as a Case Manager, BS in a health or human services related field, Previous OB/NICU experience
What You'll Do.
Perform care management within scope of licensure
and evaluate care plans
Optimize member health care across care continuum
Perform duties telephonically or on-site
Ensure member access to services
Conduct assessments to identify needs
Implement care plan by facilitating authorizations/referrals
Coordinate internal and external resources
Monitor and evaluate care plan effectiveness
Interface with Medical Directors and Physician Advisors
Negotiate rates of reimbursement
Assist in problem solving with providers
How You'll Work.
Team & Collaboration
Interfaces with Medical Directors and Physician Advisors
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