Job Description

Overview Join to apply for the Telephonic Nurse Case Manager II role at Elevance Health . Location: This role enables associates to work virtually full-time, with required in-person training sessions. Hybrid/virtual work policy applies and candidates not within a reasonable commuting distance will not be considered unless an accommodation is granted by law. Hours: Monday through Friday 11:30am – 8pm EST. Responsibilities Performs care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Duties are performed telephonically. Ensures member access to services appropriate to their health needs. Conducts assessments to identify individual needs and develops a specific care management plan to address objectives and goals identified during assessment. Implements care plan by 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 the effectiveness of the care management plan and modifies it as necessary. Interfaces with Medical Directors and Health Professionals on the development of care management treatment plans. Assists in problem solving with providers, claims or service issues. Minimum Requirements Requires a BA/BS in a health-related field; 5 years of clinical experience; or any combination of education and experience with equivalent background. Current, unrestricted RN license in applicable state(s) required. Multi-state licensure is required if this role provides services in multiple states. Preferred Capabilities, Skills and Experiences Strong clinical background in an acute care hospital setting (ER, ICU, Critical Care) preferred. Prior telephonic Case Management experience with a Managed Care Company preferred. Certification as a Case Manager. 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 quickly. Ability to manage, review and respond to emails/instant messages in a timely fashion. Managed Care (Home Health, Insurance, Inpatient) experience. Salary, Location and Benefits For candidates working in person or virtually in the listed location(s), the salary range for this position is $76,944 to $126,408. Locations: Colorado, Maryland, Massachusetts, New Jersey, Washington State. Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contributions. The salary offered is based on legitimate, non-discriminatory factors set by the Company, with equal pay opportunities for equal work. Additional Notes The salary range and compensation details may be modified in the future based on location, experience, education, and skill level. Elevance Health accepts resumes from agencies only with a signed agreement; unsolicited resumes are the property of Elevance Health. About Elevance Health Elevance Health is a health company dedicated to improving lives and communities. We are a Fortune 25 company focused on making healthcare simpler and supporting our members and associates. Equal Opportunity Elevance Health is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender, marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status protected by applicable laws. Reasonable accommodations are available for applicants during the job application process. #J-18808-Ljbffr Elevance Health

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