Nurse Case Manager II

🕒 6 days ago

🏈 Ohio, Georgia – Remote

🏈 Ohio – Remote 🍑 Georgia – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 20%

What it means: the chance that no one is really hiring for this job.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

• Manage care for members with complex and chronic care needs within the scope of licensure • Assess members and develop, implement, coordinate, monitor, and evaluate care plans • Ensure member access to services appropriate to health needs • Facilitate authorizations and referrals within the benefits structure or through extra-contractual arrangements • Coordinate internal and external resources to meet identified needs • Monitor and modify care management plans as necessary • Interface with Medical Directors and Physician Advisors on care management treatment plans • Negotiate reimbursement rates, as applicable • Assist with provider, claims, or service issue problem-solving • Assist with development of utilization and care management policies and procedures • Perform duties telephonically or on-site, including hospital discharge planning • Service members in different states

🎯 Requirements

• BA/BS in a health-related field and minimum of 5 years of clinical experience; or any combination of education and experience, which would provide an equivalent background • Current, unrestricted RN license in applicable home state required • Multi-state licensure required if providing services in multiple states • Certification as a Case Manager is preferred • Ability to work Monday-Friday EST, with one late evening from 11:30am-8:00pm per week • Ability to work one rotating Friday late night approximately 1-2 times per year • Candidates must reside within a reasonable commuting distance from the posting location(s), unless an accommodation is granted as required by law • This position is not eligible for employment-based sponsorship • New candidates in certain patient/member-facing roles must become vaccinated against COVID-19 and Influenza, unless an acceptable explanation is provided

🏖️ 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 arrangement, except for required in-person training sessions • Flexible work-life integration • Professional and personal growth opportunities

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