Nurse Case Manager Lead responsible for managing complex and chronic care needs of Elevance Health members. Ensuring proper access to health care services while coordinating care plans.
Responsibilities
responsible for care management within the scope of licensure for members with complex and chronic care needs
assesses, develops, implements, coordinates, monitors, and evaluates care plans designed to optimize member health care across the care continuum
interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans
negotiates rates of reimbursement, as applicable
assists in problem solving with providers, claims or service issues
Requirements
Requires a BA/BS in a health related field and 5 years of clinical experience
Current, unrestricted RN license in applicable state (CA) required
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