Nurse Case Manager II

🔥 2 hours ago

🌽 Illinois, Kentucky, +4 more states – Remote

🌽 Illinois – Remote 🐎 Kentucky – Remote 🏈 Ohio – Remote 🏰 Missouri – Remote ⚔️ Virginia – Remote 🧀 Wisconsin – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

👔 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 care management within the scope of licensure for members with complex and chronic care needs • Assess, develop, implement, coordinate, monitor, and evaluate care plans across the care continuum • Perform duties telephonically • Ensure member access to services appropriate to their health needs • Conduct assessments to identify individual needs and care management objectives and goals • Facilitate 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 management plan effectiveness and modify plans as necessary • Interface with Medical Directors and Physician Advisors on care management treatment plans • Negotiate rates of reimbursement, as applicable • Assist with provider, claims, or service issue problem solving • Assist with development of utilization/care management policies and procedures

🎯 Requirements

• Current, unrestricted RN license in applicable state required • Multi-state licensure required if providing services in multiple states • Multi-State Licensure required because the position services members in different states • Case Management experience • Utilization Management experience • Certification as a Case Manager • Minimum 2 years’ experience in acute care setting • 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 • Candidates must reside within commuting distance from an office unless accommodation is granted as required by law • 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, except for required in-person training sessions • Flexible work-life integration • COVID-19 and Influenza vaccination support/requirement for certain patient/member-facing roles