Nurse Case Manager II

🔥 2 minutes ago

🐎 Kentucky, New York, +1 more states – Remote

🐎 Kentucky – Remote 🗽 New York – Remote 🍑 Georgia – Remote

💵 $79.5k - $119.2k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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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 • Conduct duties telephonically or on-site, such as at hospitals for 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 problem solving • Assist with development of utilization/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, which would provide an equivalent background • Current, unrestricted RN license in applicable state(s) required • Multi-state licensure is required if providing services in multiple states • Certification as a Case Manager is preferred • BS in a health or human services related field preferred • Ability to work M-F 8am-4:30pm with 2-3 late evenings a month from 11:30am-8pm • New candidates in certain patient/member-facing roles must become vaccinated 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 and long term disability benefits • 401(k) +match • stock purchase plan • life insurance • wellness programs • financial education resources

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