Nurse Case Manager I

🔥 38 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Elevance Health

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 B2B

Healthcare • Healthcare Insurance • B2B

Elevance Health is transforming from a traditional health benefits organization into a lifetime trusted health partner, driven by a bold purpose to improve the health of humanity. With nearly 100,000 associates, they serve over 118 million people and utilize an integrated whole health approach supported by industry-leading capabilities and a digital health platform. Their mission includes redefining health, reimagining the health system, and strengthening communities.

📋 Description

• Provide telephonic care management for members with complex and chronic care needs within the scope of licensure • Assess members and develop specific care management plans • Implement care plans by facilitating authorizations and referrals within the benefits structure or through extra-contractual arrangements • Coordinate internal and external resources to meet identified needs • Monitor and evaluate care plan effectiveness and modify plans as necessary • Ensure member access to services appropriate to their health needs • Interface with Medical Directors and Physician Advisors on care management treatment plans • Assist with provider, claims, or service-related problem solving • Assist with developing utilization and care management policies and procedures • Service members in different states

🎯 Requirements

• Requires a BA/BS in a health-related field • 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background • Current, unrestricted RN license from the State of Georgia required • Multistate licensure is required if providing services in multiple states • Ability to talk and type at the same time • Certification as a Case Manager • 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 • Must reside in the State of Georgia • Must complete the online pre-employment skills assessment within 48 hours of receipt and meet the criteria • Monday–Friday availability, 11:00am–7:30pm, with one 8:30am–5:00pm EST shift per week

🏖️ Benefits

• Merit increases • Paid holidays • Paid Time Off • Incentive bonus programs • Medical benefits • Dental benefits • Vision benefits • Short-term disability benefits • Long-term disability benefits • 401(k) + match • Stock purchase plan • Life insurance • Wellness programs • Financial education resources • Virtual full-time work with flexibility and autonomy • Required in-person training sessions • Accommodation for qualifying candidates as required by law