Nurse Case Manager II

🔥 13 hours ago

🐎 Kentucky, New York – Remote

🐎 Kentucky – Remote 🗽 New York – Remote

💵 $79.5k - $119.2k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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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

• Perform 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 or on-site, such as hospital discharge planning • Ensure member access to services appropriate to health needs • Conduct assessments and create care management plans addressing identified 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 plan effectiveness and modify 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 resolution • Assist with developing utilization and care management policies and procedures

🎯 Requirements

• BA/BS in a health related field and minimum of 5 years of clinical experience; or any combination of education and experience providing an equivalent background • Current, unrestricted RN license in applicable state(s) required • Multi-state licensure required if providing services in multiple states • Certification as a Case Manager is preferred • BS in a health or human services related field is preferred • Candidates must reside within a reasonable commuting distance from the posting location(s), unless an accommodation is granted as required by law • Certain patient/member-facing roles require vaccination against COVID-19 and Influenza, unless an acceptable explanation is provided

🏖️ Benefits

• Comprehensive benefits package • Incentive and recognition programs • Equity stock purchase • 401k contribution • 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) with match • Stock purchase plan • Life insurance • Wellness programs • Financial education resources • Virtual full-time work flexibility, except for required in-person training sessions