Elevance Health
Health
NurseCaseMgr
“Nurse Case Mgr at Elevance Health. Skills: Care Management, RN License, Assessment. Perform care management within scope of licensure. Assess, develop, implement, coordinate, monitor, and evaluate care plans”
Industry & Context.
Problem solving with providers, claims or service issues
Required in-person training sessions, Candidates not within a reasonable commuting distance from the posting location(s) will not be considered, Multi-State Licensure will be required, Vaccinated against COVID-19 and Influenza (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
Nice to Have
Case Management experience, 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
What You'll Do.
Perform care management within scope of licensure
and evaluate care plans
Optimize member health care across continuum
Perform duties telephonically for discharge planning
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
How You'll Work.
Team & Collaboration
Interfaces with Medical Directors and Physician Advisors
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