Nurse Case Manager II

🔥 12 minutes ago

⛰️ Colorado, Nevada – Remote

⛰️ Colorado – Remote 🎰 Nevada – Remote

💵 $79.5k - $124.9k / 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

• Provide care management for members with complex and chronic care needs within scope of licensure • Assess members and develop individualized care management plans • Implement care plans through authorizations and referrals within benefits structures or extra-contractual arrangements • Coordinate internal and external resources • Monitor and evaluate care plan effectiveness and modify plans as needed • Interface with Medical Directors and Physician Advisors on care management treatment plans • Negotiate reimbursement rates as applicable • Assist with provider, claims, and service issue resolution • Assist with development of utilization and care management policies and procedures • Ensure member access to services appropriate to health needs • Perform duties telephonically or on-site, including hospital discharge planning

🎯 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 when providing services in multiple states • Certification as a Case Manager is preferred • BS in a health or human services-related field preferred • Monday-Friday, 10:00 am-6:30 pm EST work schedule • Candidates must reside within reasonable commuting distance of a posting location unless an accommodation is granted • 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 • 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 work flexibility • Required in-person training sessions • Incentive and recognition programs • Equity stock purchase