Hybrid RN Nurse Case Manager I

at Elevance Health

• Job title: RN Nurse Case Manager I
• Job type: Full Time
• Experience level: Mid level, Senior
• Salary: $68,880 - $113,160 per year
• Degree requirement: Bachelor's Degree
• Location requirements: Hybrid, Meridian, United States

About the role

• Telephonic RN Nurse Case Manager at Elevance Health managing complex member care needs with a focus on optimizing health care. Responsibilities include conducting assessments, implementing care plans, and coordinating resources.

Responsibilities

• Ensures members understand benefits and assist in access of services appropriate to their health needs.
• Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.
• Implements care plan through actions based on assessments including providing education, facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements.
• Coordinates internal and external resources to meet identified needs.
• Monitors and evaluates effectiveness of the care management plan and modifies as necessary.
• Interfaces with Medical Directors and other health professionals on the development of care management treatment plans.
• Assists in problem solving for members and providers related to access to care, vendors, claims or service issues, etc.

Requirements

• Requires BA/BS in a health related field and minimum of 3 years of clinical experience;
• Current, unrestricted compact RN license in your home state.
• Multi-state licensure is required if providing services in multiple states.
• Strong clinical background in hospital setting, i.e. Med Surg, ER, ICU, Critical Care
• Ability to talk, type and critically think at the same time.
• Demonstrates 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.
• Excellent collaboration, communication, and teamwork skills.

Benefits

• comprehensive benefits package
• incentive and recognition programs
• equity stock purchase
• 401k contribution
• paid holidays
• Paid Time Off
• medical, dental, vision
• short and long term disability benefits
• wellness programs
• financial education resources